{"title":"Machine Learning Integrating Quantitative MRI and Clinical Features Predicts Loss of Ambulation in Duchenne Muscular Dystrophy","authors":"Chuan Liu,Yu Song,Jiayu Wan,Ting Xu,Xinyuan Zhang,Yiqiao Yan,Hang Fu,Xiaotang Cai,Yingkun Guo,Yun Wang,Huayan Xu","doi":"10.1002/jcsm.70413","DOIUrl":"https://doi.org/10.1002/jcsm.70413","url":null,"abstract":"","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"2 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149230395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Underweight Versus Obesity and Gastrointestinal Cancer Mortality in Type 2 Diabetes: A Nationwide Cohort Study","authors":"Ji-Hong Park,Kyungdo Han,Hun Jee Choe,Se Eun Park,Won-Young Lee,Sun-Joon Moon,Eun-Jung Rhee","doi":"10.1002/jcsm.70408","DOIUrl":"https://doi.org/10.1002/jcsm.70408","url":null,"abstract":"","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"25 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149230397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Denosumab Versus Zoledronic Acid for Muscle Strength and Physical Performance in Postmenopausal Osteoporosis: A 3-Year Prospective Study","authors":"Xiangwen Li,Zineng Yuan,Nina Ma,Bijuan Huang,Hongyue Tao,Shuang Chen","doi":"10.1002/jcsm.70406","DOIUrl":"https://doi.org/10.1002/jcsm.70406","url":null,"abstract":"","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"33 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149230396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexandra M. Winant, Roger Moreno‐Justicia, Lucia Paolini, Wout J. Claassen, Coen A. C. Ottenheijm, Atul S. Deshmukh, Stefano Cattaneo, Simone Piva, Nicola Latronico, Robert A. E. Seaborne, Julien Ochala
Background Skeletal muscle atrophy is a pervasive complication of critical illness that worsens survival and recovery, yet remains poorly explained by current clinical or molecular markers. Methods To directly connect disease‐associated molecular states to the contractile machinery, this study combined sequential functional, transcriptomic and proteomic profiling of the same single human skeletal myofibres from critically ill patients in the intensive care unit with acquired weakness (ICU‐AW) and controls. This integrated approach provides a framework for validating molecular signals directly within the cellular and biomechanical context. Results Differential expression analyses between control and ICU‐AW myofibres show marked donor‐level heterogeneity, with no differentially expressed features (FDR < 0.05). Ranked gene set enrichment analyses revealed distinct transcriptional and proteomic signatures between conditions, as well as a subtle yet conserved myofibre state enriched in ICU‐AW, characterised by inflammatory and chemotactic gene programmes, intracellular structural remodelling and bioenergetic adaptation. Nineteen features were significantly (FDR < 0.05) altered at both RNA and protein levels from the same myofibre. Overall, these 19 overlapping features link an inflammatory transcriptional landscape to a proteomic shift toward mitochondrial and translational machinery, revealing a coordinated stress‐adaptation programme with selective post‐translational control in fibres from patients with ICU‐AW. Further integration with the functional dataset revealed fibres in this state displayed selectively disrupted myosin dynamics, evidenced by prolonged ATP turnover time of myosin heads in their super‐relaxed conformation, suggesting altered myosin energetics as a contributor to muscle dysfunction. Conclusions These findings define a discrete, disease‐associated myofibre state and validate a proof‐of‐concept integrative single‐fibre framework for connecting multi‐omic heterogeneity to molecular motor function in complex human disease. The identification of coordinated transcriptomic and proteomic programmes, validated through functional measurement, suggests that targeting this fibre state may offer new therapeutic opportunities in ICU‐acquired dysfunction and related muscle disorders.
{"title":"Integrated Single‐Myofibre Multi‐Omics Correlates Inflammatory State to Myosin Energetics in ICU‐Acquired Weakness","authors":"Alexandra M. Winant, Roger Moreno‐Justicia, Lucia Paolini, Wout J. Claassen, Coen A. C. Ottenheijm, Atul S. Deshmukh, Stefano Cattaneo, Simone Piva, Nicola Latronico, Robert A. E. Seaborne, Julien Ochala","doi":"10.1002/jcsm.70407","DOIUrl":"https://doi.org/10.1002/jcsm.70407","url":null,"abstract":"Background Skeletal muscle atrophy is a pervasive complication of critical illness that worsens survival and recovery, yet remains poorly explained by current clinical or molecular markers. Methods To directly connect disease‐associated molecular states to the contractile machinery, this study combined sequential functional, transcriptomic and proteomic profiling of the same single human skeletal myofibres from critically ill patients in the intensive care unit with acquired weakness (ICU‐AW) and controls. This integrated approach provides a framework for validating molecular signals directly within the cellular and biomechanical context. Results Differential expression analyses between control and ICU‐AW myofibres show marked donor‐level heterogeneity, with no differentially expressed features (FDR < 0.05). Ranked gene set enrichment analyses revealed distinct transcriptional and proteomic signatures between conditions, as well as a subtle yet conserved myofibre state enriched in ICU‐AW, characterised by inflammatory and chemotactic gene programmes, intracellular structural remodelling and bioenergetic adaptation. Nineteen features were significantly (FDR < 0.05) altered at both RNA and protein levels from the same myofibre. Overall, these 19 overlapping features link an inflammatory transcriptional landscape to a proteomic shift toward mitochondrial and translational machinery, revealing a coordinated stress‐adaptation programme with selective post‐translational control in fibres from patients with ICU‐AW. Further integration with the functional dataset revealed fibres in this state displayed selectively disrupted myosin dynamics, evidenced by prolonged ATP turnover time of myosin heads in their super‐relaxed conformation, suggesting altered myosin energetics as a contributor to muscle dysfunction. Conclusions These findings define a discrete, disease‐associated myofibre state and validate a proof‐of‐concept integrative single‐fibre framework for connecting multi‐omic heterogeneity to molecular motor function in complex human disease. The identification of coordinated transcriptomic and proteomic programmes, validated through functional measurement, suggests that targeting this fibre state may offer new therapeutic opportunities in ICU‐acquired dysfunction and related muscle disorders.","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"48 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Sarcopenic obesity is associated with a significant increase in morbidity and mortality, particularly in older adults. Common measures of sarcopenic obesity consider obesity and sarcopenia independently, despite their potentially synergistic harmful effects. The fat mass to fat‐free mass ratio (FM/FFM) is an integrated measure of sarcopenic obesity that provides more useful information than measures that consider sarcopenia and obesity separately. The objectives of this study are to develop age‐ and sex‐specific FM/FFM percentile curves for older adults and describe age‐ and sex‐related patterns of FM/FFM percentiles. Methods Data from the Canadian Longitudinal Study on Aging (CLSA) were used ( n = 28 791). FM/FFM was calculated as the ratio of total body fat mass (kg) to total body lean mass (kg) from dual‐energy X‐ray absorptiometry (DXA) scan. Weighted age‐ and sex‐specific FM/FFM curves for the 1st, 5th, 25th, 50th, 75th, 95th and 99th percentiles were calculated using the LMS method. LMS provides a summary of the changing distribution of the measurement of interest by the three curves, lambda for the skewness (L), mu for the median (M) and sigma for the coefficient of variation (S). Weighted percentile curves were plotted with age (45–86 years) on the x ‐axis and FM/FFM on the y ‐axis for males and females, respectively. Results Mean age of the CLSA at baseline was 59.6 ± 10.2 years, and 47.4% were males. For men, FM/FFM percentiles appear to increase slowly with aging and then stabilise after age 70. For women, FM/FFM percentiles appear to start at a higher value and increase more rapidly with aging, stabilising but then showing a stronger downward trend than males after age 65. At the 50th percentile, the maximum FM/FFM value is 0.42 at age 86 years for males and 0.71 at age 68 years for females. Conclusions The present study highlights the important age‐ and sex‐related differences in FM/FFM percentiles in older adults. The FM/FFM curves could be used as a tool for identifying older adults with sarcopenic obesity and examining health risks associated with sarcopenic obesity.
{"title":"Age‐ and Sex‐Specific Percentile Curves for the FM/FFM Ratio Using Data From the Canadian Longitudinal Study on Aging","authors":"Chris Kim, Claire E. Cook, Hailey R. Banack","doi":"10.1002/jcsm.70399","DOIUrl":"https://doi.org/10.1002/jcsm.70399","url":null,"abstract":"Background Sarcopenic obesity is associated with a significant increase in morbidity and mortality, particularly in older adults. Common measures of sarcopenic obesity consider obesity and sarcopenia independently, despite their potentially synergistic harmful effects. The fat mass to fat‐free mass ratio (FM/FFM) is an integrated measure of sarcopenic obesity that provides more useful information than measures that consider sarcopenia and obesity separately. The objectives of this study are to develop age‐ and sex‐specific FM/FFM percentile curves for older adults and describe age‐ and sex‐related patterns of FM/FFM percentiles. Methods Data from the Canadian Longitudinal Study on Aging (CLSA) were used ( <jats:italic>n</jats:italic> = 28 791). FM/FFM was calculated as the ratio of total body fat mass (kg) to total body lean mass (kg) from dual‐energy X‐ray absorptiometry (DXA) scan. Weighted age‐ and sex‐specific FM/FFM curves for the 1st, 5th, 25th, 50th, 75th, 95th and 99th percentiles were calculated using the LMS method. LMS provides a summary of the changing distribution of the measurement of interest by the three curves, lambda for the skewness (L), mu for the median (M) and sigma for the coefficient of variation (S). Weighted percentile curves were plotted with age (45–86 years) on the <jats:italic>x</jats:italic> ‐axis and FM/FFM on the <jats:italic>y</jats:italic> ‐axis for males and females, respectively. Results Mean age of the CLSA at baseline was 59.6 ± 10.2 years, and 47.4% were males. For men, FM/FFM percentiles appear to increase slowly with aging and then stabilise after age 70. For women, FM/FFM percentiles appear to start at a higher value and increase more rapidly with aging, stabilising but then showing a stronger downward trend than males after age 65. At the 50th percentile, the maximum FM/FFM value is 0.42 at age 86 years for males and 0.71 at age 68 years for females. Conclusions The present study highlights the important age‐ and sex‐related differences in FM/FFM percentiles in older adults. The FM/FFM curves could be used as a tool for identifying older adults with sarcopenic obesity and examining health risks associated with sarcopenic obesity.","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"52 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149130497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Reynolds, N. M. George, A. Papadopoulou, B. Creagh‐Brown
Background Muscle wasting in the perioperative period is a frequent and clinically significant complication following major abdominal surgery and is associated with adverse outcomes, including increased postoperative complications, prolonged hospitalisation and worsened mortality. Despite its prevalence, the magnitude and course of perioperative muscle wasting (POMW) remain incompletely understood, and current interventions are limited. Current definitions applied to sarcopenia do not suitably apply to cohorts undergoing major abdominal surgery, and therefore, we propose the concept of POMW, defined as POMW within 6 weeks of surgery. These systematic review and meta‐analysis aim to assess the extent of POMW and synthesise evidence on its clinical impact and potential interventions. Methods The electronic databases MEDLINE, EMBASE and Cochrane CENTRAL were searched from their inception to June 2025. Studies with preoperative and postoperative assessments of muscle wasting and/or function within 6 weeks of major abdominal surgery were included. Methodological quality and risk of bias were assessed with the Revised Cochrane model and Newcastle–Ottawa Scale, where appropriate. Meta‐analysis was conducted using a random‐effects model, with standardised mean changes (SMCs) as effect size metrics. The primary outcome was change in skeletal muscle mass/size within 2 and 6 weeks postoperatively, and the secondary outcome was change in muscle strength. Results A systematic review identified 45 studies ( n = 5283 patients) evaluating perioperative changes in skeletal muscle mass/dimensions and/or function within 6 weeks of major abdominal surgery. A meta‐analysis of 17 studies ( n = 2213 patients) was conducted, and significant reductions in muscle mass/size were observed at ≤ 2 weeks (SMC = 0.34; 95% CI: 0.19–0.49) and 3–6 weeks postoperatively (SMC = 0.39; 95% CI: 0.24–0.54). Muscle strength, primarily assessed via handgrip dynamometry, also declined significantly (SMC = 0.79; 95% CI: 0.12–1.46). Heterogeneity was high but findings remained robust in sensitivity analyses. Functional impairments and greater muscle wasting were consistently associated with poorer clinical outcomes. Conclusions POMW is common, rapid in onset and clinically relevant. Current management strategies are inadequate. There is an urgent need for early identification, standardised monitoring and targeted interventions to prevent postoperative functional decline and improve surgical outcomes. PROSPERO Registration: CRD420250606177
{"title":"A Systematic Review and Meta‐Analysis of Perioperative Muscle Wasting Following Major Abdominal Surgery","authors":"A. Reynolds, N. M. George, A. Papadopoulou, B. Creagh‐Brown","doi":"10.1002/jcsm.70379","DOIUrl":"https://doi.org/10.1002/jcsm.70379","url":null,"abstract":"Background Muscle wasting in the perioperative period is a frequent and clinically significant complication following major abdominal surgery and is associated with adverse outcomes, including increased postoperative complications, prolonged hospitalisation and worsened mortality. Despite its prevalence, the magnitude and course of perioperative muscle wasting (POMW) remain incompletely understood, and current interventions are limited. Current definitions applied to sarcopenia do not suitably apply to cohorts undergoing major abdominal surgery, and therefore, we propose the concept of POMW, defined as POMW within 6 weeks of surgery. These systematic review and meta‐analysis aim to assess the extent of POMW and synthesise evidence on its clinical impact and potential interventions. Methods The electronic databases MEDLINE, EMBASE and Cochrane CENTRAL were searched from their inception to June 2025. Studies with preoperative and postoperative assessments of muscle wasting and/or function within 6 weeks of major abdominal surgery were included. Methodological quality and risk of bias were assessed with the Revised Cochrane model and Newcastle–Ottawa Scale, where appropriate. Meta‐analysis was conducted using a random‐effects model, with standardised mean changes (SMCs) as effect size metrics. The primary outcome was change in skeletal muscle mass/size within 2 and 6 weeks postoperatively, and the secondary outcome was change in muscle strength. Results A systematic review identified 45 studies ( <jats:italic>n</jats:italic> = 5283 patients) evaluating perioperative changes in skeletal muscle mass/dimensions and/or function within 6 weeks of major abdominal surgery. A meta‐analysis of 17 studies ( <jats:italic>n</jats:italic> = 2213 patients) was conducted, and significant reductions in muscle mass/size were observed at ≤ 2 weeks (SMC = 0.34; 95% CI: 0.19–0.49) and 3–6 weeks postoperatively (SMC = 0.39; 95% CI: 0.24–0.54). Muscle strength, primarily assessed via handgrip dynamometry, also declined significantly (SMC = 0.79; 95% CI: 0.12–1.46). Heterogeneity was high but findings remained robust in sensitivity analyses. Functional impairments and greater muscle wasting were consistently associated with poorer clinical outcomes. Conclusions POMW is common, rapid in onset and clinically relevant. Current management strategies are inadequate. There is an urgent need for early identification, standardised monitoring and targeted interventions to prevent postoperative functional decline and improve surgical outcomes. PROSPERO Registration: CRD420250606177","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"8 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149130498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Frailty predicts poor outcomes in older adults with cardiovascular disease (CVD) and is closely related to neuromuscular dysfunction. Lower limb surface electromyography (sEMG) during walking may capture frailty‐related motor alterations, but its characteristics and discriminative value in older adults with CVD remain unclear. This study aimed to compare lower limb sEMG features between frail and nonfrail older adults with CVD and evaluate their ability to identify frailty. Methods This case–control study included 150 older adults with CVD (75 frail, 75 nonfrail; 80 men, 70 women). Frailty was defined using the Fried frailty phenotype. Wireless sEMG signals were recorded bilaterally from the rectus femoris, semitendinosus, tibialis anterior and medial gastrocnemius during a standardized 10‐m walk test. Time‐domain parameters, frequency‐domain parameters, symmetry indices, contribution ratios and activation‐sequence rank were compared with false‐discovery‐rate correction. Binary logistic regression and receiver operating characteristic (ROC) analysis were used to identify factors independently associated with frailty and evaluate discriminative performance. Results Frail participants were older (76.04 ± 7.57 vs. 68.55 ± 6.09 years), more frequently exposed to polypharmacy (93.33% vs 70.67%), required longer to complete the 10‐m walk test (13.34 ± 3.23 vs. 9.44 ± 1.21 s) and had lower Tinetti Performance‐Oriented Mobility Assessment (POMA) scores (21.51 ± 4.27 vs. 27.59 ± 0.92; all <jats:italic>p</jats:italic> < 0.001). The frail group showed higher median integrated EMG (IEMG) of the left semitendinosus (534.4 [451.3, 680.7] vs. 455.5 [384.5, 542.0] μV·s, FDR‐adjusted <jats:italic>p</jats:italic> = 0.0084) and higher activation‐sequence rank of the left rectus femoris (4.333 [3.000, 5.667] vs. 3.333 [2.333, 4.333], FDR‐adjusted <jats:italic>p</jats:italic> = 0.0404). In the frequency domain, median frequency (MF) was higher in the right rectus femoris, bilateral tibialis anterior and right medial gastrocnemius, whereas mean power frequency (MPF) was higher in six muscles (all FDR‐adjusted <jats:italic>p</jats:italic> < 0.05). In multivariable analysis, MF of the right rectus femoris (OR = 1.067, 95% CI 1.003–1.135, <jats:italic>p</jats:italic> = 0.038), MF of the right medial gastrocnemius (OR = 1.054, 95% CI 1.009–1.102, <jats:italic>p</jats:italic> = 0.019), activation‐sequence rank of the right tibialis anterior (OR = 0.640, 95% CI 0.448–0.914, <jats:italic>p</jats:italic> = 0.014), age (OR = 1.128, 95% CI 1.044–1.218, <jats:italic>p</jats:italic> = 0.002) and Tinetti POMA score (OR = 0.784, 95% CI 0.669–0.918, <jats:italic>p</jats:italic> = 0.003) were independently associated with frailty. The sEMG + age model achieved an area under the curve (AUC) of 0.8418 (sensitivity = 0.8933; specificity = 0.6400), approaching the full model including Tinetti POMA score (AUC = 0.8740; sensitivity = 0.9200; specificity = 0.7067). Conclusi
背景：虚弱预示着老年心血管疾病（CVD）患者预后不良，并且与神经肌肉功能障碍密切相关。行走时的下肢表面肌电图（sEMG）可以捕捉到与虚弱相关的运动改变，但其特征和在老年CVD患者中的鉴别价值尚不清楚。本研究旨在比较虚弱和非虚弱老年CVD患者的下肢肌电信号特征，并评估他们识别虚弱的能力。方法本病例对照研究纳入了150例老年CVD患者（75例体弱，75例非体弱；80例男性，70例女性）。脆性是用Fried脆性表型定义的。在标准化的10米步行测试中，记录双侧股直肌、半腱肌、胫骨前肌和腓肠肌内侧的无线肌电信号。我们比较了时域参数、频域参数、对称指数、贡献率和激活序列等级的错误发现率校正。使用二元逻辑回归和受试者工作特征（ROC）分析来识别与虚弱独立相关的因素，并评估鉴别表现。结果虚弱的参与者年龄较大（76.04±7.57岁vs 68.55±6.09岁），更频繁地使用多种药物（93.33% vs 70.67%），需要更长的时间来完成10米步行测试（13.34±3.23秒vs 9.44±1.21秒），并且Tinetti性能取向运动能力评估（POMA）得分较低（21.51±4.27比27.59±0.92，均p <； 0.001）。虚弱组左半腰肌的中位综合肌电信号（IEMG）较高（534.4 [451.3,680.7]vs. 455.5 [384.5, 542.0] μV·s， FDR校正p = 0.0084），左侧股直肌的激活序列等级较高（4.333 [3.000,5.667]vs. 3.333 [2.333, 4.333]， FDR校正p = 0.0404）。在频域，右股直肌、双侧胫骨前肌和右腓肠肌内侧肌的中位频率（MF）较高，而六块肌肉的平均工频（MPF）较高（均经FDR校正p <； 0.05）。在多变量分析中，右侧股直肌的MF （OR = 1.067, 95% CI 1.003-1.135, p = 0.038）、右侧腓肠肌内侧的MF （OR = 1.054, 95% CI 1.009-1.102, p = 0.019）、右侧胫骨前肌的激活序列等级（OR = 0.640, 95% CI 0.448-0.914, p = 0.014）、年龄（OR = 1.128, 95% CI 1.044-1.218, p = 0.002）和Tinetti POMA评分（OR = 0.784, 95% CI 0.669-0.918, p = 0.003）与虚弱独立相关。sEMG + age模型的曲线下面积（AUC）为0.8418（灵敏度= 0.8933，特异性= 0.6400），接近包含Tinetti POMA评分的完整模型（AUC = 0.8740，灵敏度= 0.9200，特异性= 0.7067）。结论：老年CVD患者行走时下肢肌电信号特征与虚弱独立相关。简化的肌电图+年龄模型具有良好的判别性能，可以为传统的衰弱评估提供候选的客观指标。
{"title":"Surface Electromyographic Characteristics of Lower Limb Muscles in Frail Older Adults With Cardiovascular Disease: A Case–Control Study","authors":"Pingping Huang, Shiqi Chen, Linjing Wu, Jiahua Li, Rongxiang Zhang, Shufen Liu, Yuan Chen","doi":"10.1002/jcsm.70387","DOIUrl":"https://doi.org/10.1002/jcsm.70387","url":null,"abstract":"Background Frailty predicts poor outcomes in older adults with cardiovascular disease (CVD) and is closely related to neuromuscular dysfunction. Lower limb surface electromyography (sEMG) during walking may capture frailty‐related motor alterations, but its characteristics and discriminative value in older adults with CVD remain unclear. This study aimed to compare lower limb sEMG features between frail and nonfrail older adults with CVD and evaluate their ability to identify frailty. Methods This case–control study included 150 older adults with CVD (75 frail, 75 nonfrail; 80 men, 70 women). Frailty was defined using the Fried frailty phenotype. Wireless sEMG signals were recorded bilaterally from the rectus femoris, semitendinosus, tibialis anterior and medial gastrocnemius during a standardized 10‐m walk test. Time‐domain parameters, frequency‐domain parameters, symmetry indices, contribution ratios and activation‐sequence rank were compared with false‐discovery‐rate correction. Binary logistic regression and receiver operating characteristic (ROC) analysis were used to identify factors independently associated with frailty and evaluate discriminative performance. Results Frail participants were older (76.04 ± 7.57 vs. 68.55 ± 6.09 years), more frequently exposed to polypharmacy (93.33% vs 70.67%), required longer to complete the 10‐m walk test (13.34 ± 3.23 vs. 9.44 ± 1.21 s) and had lower Tinetti Performance‐Oriented Mobility Assessment (POMA) scores (21.51 ± 4.27 vs. 27.59 ± 0.92; all <jats:italic>p</jats:italic> < 0.001). The frail group showed higher median integrated EMG (IEMG) of the left semitendinosus (534.4 [451.3, 680.7] vs. 455.5 [384.5, 542.0] μV·s, FDR‐adjusted <jats:italic>p</jats:italic> = 0.0084) and higher activation‐sequence rank of the left rectus femoris (4.333 [3.000, 5.667] vs. 3.333 [2.333, 4.333], FDR‐adjusted <jats:italic>p</jats:italic> = 0.0404). In the frequency domain, median frequency (MF) was higher in the right rectus femoris, bilateral tibialis anterior and right medial gastrocnemius, whereas mean power frequency (MPF) was higher in six muscles (all FDR‐adjusted <jats:italic>p</jats:italic> < 0.05). In multivariable analysis, MF of the right rectus femoris (OR = 1.067, 95% CI 1.003–1.135, <jats:italic>p</jats:italic> = 0.038), MF of the right medial gastrocnemius (OR = 1.054, 95% CI 1.009–1.102, <jats:italic>p</jats:italic> = 0.019), activation‐sequence rank of the right tibialis anterior (OR = 0.640, 95% CI 0.448–0.914, <jats:italic>p</jats:italic> = 0.014), age (OR = 1.128, 95% CI 1.044–1.218, <jats:italic>p</jats:italic> = 0.002) and Tinetti POMA score (OR = 0.784, 95% CI 0.669–0.918, <jats:italic>p</jats:italic> = 0.003) were independently associated with frailty. The sEMG + age model achieved an area under the curve (AUC) of 0.8418 (sensitivity = 0.8933; specificity = 0.6400), approaching the full model including Tinetti POMA score (AUC = 0.8740; sensitivity = 0.9200; specificity = 0.7067). Conclusi","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"9 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149086727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Imanol Reparaz‐Escudero, Mikel Izquierdo, Mirian Ecay‐Torres, Miren Altuna, Carolina López, Ainara Estanga, Maite García‐Sebastián, María de Arriba, Naia Ros, Jon Saldias, Marina Limousin, Pablo Martínez‐Lage, Mikel L. Sáez de Asteasu
Background Preservation of executive function is vital for independence and dementia prevention, yet the physical performance levels at which age‐related executive vulnerability becomes detectable remain uncertain. This study examined whether gait speed, handgrip strength and leg muscle power influence the relationship between age and executive function in older adults at increased dementia risk and assessed how sex and white matter hyperintensity (WMH) burden affect this relationship. Methods Cross‐sectional analysis of 920 community‐dwelling older adults (aged 60–85) at high dementia risk, enrolled in the CITA GO‐ON trial. Executive function was measured by the Trail Making Test (TMT B minus A) and the Stroop interference score. Physical performance included gait speed, handgrip strength and peak leg muscle power. Moderation analyses tested whether physical performance moderated the age–executive function association, adjusting for sex, socioeconomic status, depressive symptoms, cardiometabolic conditions, BMI and smoking; three‐way interactions tested sex effects. The Johnson–Neyman technique identified regions of significance, the range of performance values over which the age–executive function association was statistically detectable. Sensitivity analyses included cognitively healthy participants and WMH adjustment. Results The average (SD) age was 69.5 (6.2) years; 48.4% were female, and average education was 13.0 (4.5) years. At baseline, 63 participants (6.8%) had mild cognitive impairment. Gait speed ( <jats:italic>β</jats:italic> = −0.27, <jats:italic>p</jats:italic> < 0.05), handgrip strength ( <jats:italic>β</jats:italic> = −0.08, <jats:italic>p</jats:italic> < 0.05) and peak leg muscle power ( <jats:italic>β</jats:italic> = −0.007, <jats:italic>p</jats:italic> < 0.05) moderated the age–executive function link. Johnson–Neyman regions‐of‐significance were located in the upper range of the performance distribution. For TMT B minus A, the age–executive function association was statistically detectable below gait speed 1.83 m/s, handgrip 48.8 kg and leg power 438 W (1.0%–4.8% of participants), whereas for Stroop interference the corresponding values were lower (gait 1.68 m/s, handgrip 43.9 kg, leg power 366 W; up to 15.9% of participants). In sex‐stratified analyses, gait speed moderated the age–executive function association for TMT B minus A in males and for Stroop interference in females. WMH burden was not independently associated with executive function. Conclusions In older adults at increased dementia risk, higher physical performance was associated with a weaker relationship between age and executive function, independent of socioeconomic, emotional, body composition and cardiovascular factors. This moderation was most consistent for gait speed, with a sex pattern that differed by outcome. Longitudinal studies are needed to test whether maintaining high physical performance helps preserve executive function and inform pr
背景：执行功能的保留对于独立性和痴呆症的预防至关重要，然而，与年龄相关的执行脆弱性的身体表现水平仍然不确定。本研究考察了步态速度、握力和腿部肌肉力量是否会影响痴呆风险增加的老年人的年龄和执行功能之间的关系，并评估了性别和白质高强度（WMH）负担如何影响这种关系。方法对920名社区居住老年人（60-85岁）的高痴呆风险进行横断面分析，这些老年人参加了CITA GO‐ON试验。执行功能采用Trail Making Test （TMT B - A）和Stroop interference score进行测量。身体表现包括步态速度、握力和腿部肌肉力量峰值。适度分析测试了身体表现是否调节了年龄-执行功能的关联，调整了性别、社会经济地位、抑郁症状、心脏代谢状况、体重指数和吸烟；三方互动测试了性别效应。约翰逊-内曼技术确定了显著区域，即年龄-执行功能关联在统计上可检测到的表现值范围。敏感性分析包括认知健康的参与者和WMH调整。结果平均（SD）年龄为69.5（6.2）岁；女性占48.4%，平均受教育年限为13.0（4.5）年。在基线时，63名参与者（6.8%）有轻度认知障碍。步态速度（β = - 0.27, p < 0.05）、握力（β = - 0.08, p < 0.05）和腿部肌肉力量峰值（β = - 0.007, p < 0.05）调节了年龄-执行功能的关联。Johnson-Neyman显著区位于性能分布的上范围。对于TMT B - A，在步态速度1.83 m/s、握力48.8 kg和腿力438 W（1.0%-4.8%）以下，年龄-执行功能的关联在统计学上是可检测到的，而对于Stroop干扰，相应的值较低（步态1.68 m/s、握力43.9 kg、腿力366 W，高达15.9%的参与者）。在性别分层分析中，步态速度调节了男性TMT B - A和女性Stroop干扰的年龄-执行功能关联。WMH负担与执行功能没有独立关联。结论：在痴呆风险增加的老年人中，较高的身体表现与年龄和执行功能之间的关系较弱，独立于社会经济、情绪、身体成分和心血管因素。这种缓和在步态速度上最为一致，性别模式因结果而异。需要进行纵向研究，以测试保持高水平的身体表现是否有助于保持执行功能，并为预防策略提供信息。
{"title":"Physical Performance Moderates the Association Between Age and Executive Function in Older Adults at Elevated Risk of Dementia: Cross‐Sectional Analysis From the CITA GO‐ON Trial","authors":"Imanol Reparaz‐Escudero, Mikel Izquierdo, Mirian Ecay‐Torres, Miren Altuna, Carolina López, Ainara Estanga, Maite García‐Sebastián, María de Arriba, Naia Ros, Jon Saldias, Marina Limousin, Pablo Martínez‐Lage, Mikel L. Sáez de Asteasu","doi":"10.1002/jcsm.70396","DOIUrl":"https://doi.org/10.1002/jcsm.70396","url":null,"abstract":"Background Preservation of executive function is vital for independence and dementia prevention, yet the physical performance levels at which age‐related executive vulnerability becomes detectable remain uncertain. This study examined whether gait speed, handgrip strength and leg muscle power influence the relationship between age and executive function in older adults at increased dementia risk and assessed how sex and white matter hyperintensity (WMH) burden affect this relationship. Methods Cross‐sectional analysis of 920 community‐dwelling older adults (aged 60–85) at high dementia risk, enrolled in the CITA GO‐ON trial. Executive function was measured by the Trail Making Test (TMT B minus A) and the Stroop interference score. Physical performance included gait speed, handgrip strength and peak leg muscle power. Moderation analyses tested whether physical performance moderated the age–executive function association, adjusting for sex, socioeconomic status, depressive symptoms, cardiometabolic conditions, BMI and smoking; three‐way interactions tested sex effects. The Johnson–Neyman technique identified regions of significance, the range of performance values over which the age–executive function association was statistically detectable. Sensitivity analyses included cognitively healthy participants and WMH adjustment. Results The average (SD) age was 69.5 (6.2) years; 48.4% were female, and average education was 13.0 (4.5) years. At baseline, 63 participants (6.8%) had mild cognitive impairment. Gait speed ( <jats:italic>β</jats:italic> = −0.27, <jats:italic>p</jats:italic> < 0.05), handgrip strength ( <jats:italic>β</jats:italic> = −0.08, <jats:italic>p</jats:italic> < 0.05) and peak leg muscle power ( <jats:italic>β</jats:italic> = −0.007, <jats:italic>p</jats:italic> < 0.05) moderated the age–executive function link. Johnson–Neyman regions‐of‐significance were located in the upper range of the performance distribution. For TMT B minus A, the age–executive function association was statistically detectable below gait speed 1.83 m/s, handgrip 48.8 kg and leg power 438 W (1.0%–4.8% of participants), whereas for Stroop interference the corresponding values were lower (gait 1.68 m/s, handgrip 43.9 kg, leg power 366 W; up to 15.9% of participants). In sex‐stratified analyses, gait speed moderated the age–executive function association for TMT B minus A in males and for Stroop interference in females. WMH burden was not independently associated with executive function. Conclusions In older adults at increased dementia risk, higher physical performance was associated with a weaker relationship between age and executive function, independent of socioeconomic, emotional, body composition and cardiovascular factors. This moderation was most consistent for gait speed, with a sex pattern that differed by outcome. Longitudinal studies are needed to test whether maintaining high physical performance helps preserve executive function and inform pr","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"10 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149087406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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