ECSS Paris 2023: OP-MH05
INTRODUCTION: Aging is characterized by structural and functional decline, including reduced muscle quality, altered hydration, and impaired cellular integrity, increasing the risk of sarcopenia. Bioelectrical impedance vector analysis (BIVA) is a non-invasive approach for assessing tissue properties without predictive equations, while phase angle (PhA) is a derived bioelectrical parameter that may help identify older individuals at risk of frailty. The aim of this study was to investigate the relationship between functional parameters, sarcopenia categories, and BIVA patterns in older adults, and to establish sex- and age-specific reference values for BIVA and PhA. METHODS: This multicenter cross-sectional study included 449 Spanish older adults (322 females, F; 127 males, M; 74.1 ± 8.1 yrs). Body composition was assessed using phase-sensitive bioelectrical impedance (50 kHz), with resistance (R) and reactance (Xc) normalized for stature and plotted on the RXc graph according to the BIVA approach. Muscle function was evaluated by handgrip strength (HS), 5-times sit-to-stand (STS), and lower (LS) and upper (US) isometric strength. Participants were classified into five groups for age and sarcopenia categories according to the European Consensus [1]. Associations between PhA and functional parameters were examined using correlation analysis. Differences across age groups, functional tertiles, and sarcopenia categories were analyzed using univariate analyses, ANOVA, and multivariate vector comparisons, including Hotelling’s T² and Mahalanobis distance (D). RESULTS: Sex-specific BIVA tolerance ellipses (50%, 75%, 95%) and PhA percentiles by sex and age were generated. In both sexes, vectors shifted toward the lower-right quadrant with aging (F: D = 1.20–1.53 range, p < .001; M: D = 0.83–1.53 range, p ≤ .01). PhA decreased across age groups in both sexes (F: 5.66 ± 0.40° to 4.78 ± 0.65°, p < .001; M: 6.05 ± 0.82° to 5.05 ± 0.66°, p = .05) and showed significant correlations with HS, LS, and US (F: r = 0.28, r = 0.34; r = 0.25; M: r = 0.26, r = 0.44; r = 0.38, respectively; all p <.001). Significant differences in BIVA patterns were observed between the lowest and highest functional tertiles for HS, LS, and US (F: D = 0.53–1.14, D = 0.41–0.98, D = 0.46–1.13 ranges; M: D = 1.16–1.52, D = 0.71–1.78, D = 1.19–1.59 ranges, respectively; all p < .001). Significant differences were observed between non-sarcopenic and severe sarcopenia groups (F: D = 1.86–2.82 range; M: D = 2.70–3.00 range; all p < .001). CONCLUSION: BIVA and PhA effectively discriminate functional status and sarcopenia severity in older adults. Their association with muscle strength supports their role as indicators of tissue quality and functional impairment, providing clinically relevant reference values for early risk identification and targeted interventions. Reference: [1] Lopes NC, et al. (2025). doi: 10.1016/j.nut.2024.112654
Read CV Sofia SerafiniECSS Paris 2023: OP-MH05
INTRODUCTION: Individuals with chronic heart failure (CHF) and sarcopenia often experience severe exercise intolerance and reduced quality of life (QOL). While physical exercise is a highly effective treatment for these conditions, cardiac rehabilitation remains significantly underutilized due to various barriers. Eccentric cycling (EC) has emerged as a promising, low-metabolic demand modality that offers superior or equal physiological benefits with reduced cardiorespiratory strain compared to conventional training. However, research has focused primarily on quantitative physiological outcomes, leaving a gap in understanding participants' experiences. This study aimed to gather in-depth insights into participants’ motivations, perceptions, and challenges of a 12-week aerobic EC program among older adults with CHF and sarcopenia to inform better program design and improve clinical adherence. METHODS: A qualitative approach was adopted using three semi-structured focus groups with 14 older adults (12 men, 2 women; 75.7 ± 4 years) who completed a 12-week EC program. Data were analysed using Braun and Clarke’s six-phase thematic analysis approach. Codes were refined and organized into broader categories (subthemes) and developed into themes through collaborative discussions between the two independent coders. RESULTS: Three main themes emerged: (1) Motivation and expectation where initial engagement was driven by medical and family support, while adherence was sustained by personal goals for functional gain; (2) Perceived safety, acceptability, and functional benefit, participants reported a high degree of perceived safety and psychological acceptability, rooted in the dual expertise of the clinical team and a gradual training progression that mitigated initial muscle soreness. Additionally, significant functional gains were recognized by both participants and their social circles, positively impacting perceived QOL; and (3) Challenges, which included physical discomfort, but did not lead to discontinuation. Furthermore, logistical difficulties, including training frequency and the lack of structured guidance post-intervention, were identified as significant threats to long-term adherence. CONCLUSION: Aerobic EC is perceived as a safe, feasible, and beneficial intervention by older adults with CHF and sarcopenia. Feasibility is strongly linked to professional supervision, structured clinical support, and the inherent safety of the EC ergometer. These findings suggest that EC can be an effective modality for sustaining long-term engagement and provide a foundation for refining rehabilitation strategies specifically tailored for individuals with severe exercise intolerance.
Read CV Mahsa AminiECSS Paris 2023: OP-MH05
INTRODUCTION: Sarcopenia is the accelerated loss of skeletal muscle mass and function that is associated with increased adverse outcomes including falls, functional decline, frailty, and mortality. It influenced not only by contemporaneous risk factors, but also by lifestyle factors operating across the life course. However, the spatial distribution characteristics and influencing factors of sarcopenia among Chinese older adults are complex and multifactorial and has not been fully elucidated. In this study, we aimed to: (1) analyze the spatial distribution of sarcopenia across 31 PLADs in China; (2) identify the primary drivers of sarcopenia among older adults; and (3) elucidate the complex nonlinear relationships and potential threshold effects between various determinants and sarcopenia. METHODS: Data were derived from the 2025 Sixth National Physical Fitness Surveillance(NPFS), focusing on adults aged 65-79 years. Global and local Spatial Autocorrelation Analysis were assessed using Moran’s I and Getis-Ord Gi* statistics. Geographic data—including annual mean temperature, precipitation, normalized difference vegetation index (NDVI), population, nighttime light, and per capita sports facility area—were integrated. An XGBoost model combined with SHAP values was employed to quantify feature importance, identify nonlinear associations and threshold effects. RESULTS: In 2025, the weighted prevalence of sarcopenia among Chinese older adults was 6.4% (95%CI: 5.6%-7.1%). Sarcopenia prevalence displayed significant positive spatial autocorrelation (Moran’s I=0.141, P=0.017). High-prevalence clusters were concentrated in Tibet and several southwestern provinces, while low-prevalence clusters predominated in parts of North, Northeast, and East China. Among the examined factors, per capita sports facility area exerted the strongest influence (mean SHAP value=0.168, accounting for 23.61%), followed by behavioral indicators such as session duration of physical activity. Protective factors included per capita sports facility area, population density, nighttime light, session duration of physical activity, weekly frequency of physical activity, and weekly frequency of strength training. In contrast, NDVI, daily sedentary time, and perceived exertion during exercise showed positive associations. Interestingly, these relationships displayed threshold dependence. Sarcopenia risk was consistently lower at thresholds of: ≥2.5 m²/person for per capita sports facility area, ≥30 min/session for physical activity duration, ≥3 sessions/week for physical activity frequency, and ≥1 session/week for strength training. CONCLUSION: In 2025, the prevalence of sarcopenia among Chinese older adults aged 65-79 demonstrated significant localized spatial clustering. A comprehensive prevention strategy requires a multi-level approach, combining macro-level policies for equitable public sports infrastructure with micro-level initiatives that promote enduring healthy behaviors, thereby building an integrated prevention system.
Read CV wang chenglongECSS Paris 2023: OP-MH05