Sánchez Sánchez, Juan Luis
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Sánchez Sánchez
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Juan Luis
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Ciencias de la Salud
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Publication Open Access Effects of a 12-week Vivifrail exercise program on intrinsic capacity among frail cognitively impaired community-dwelling older adults: secondary analysis of a multicentre randomised clinical trial(Oxford University Press, 2022) Sánchez Sánchez, Juan Luis; Souto Barreto, Philipe de; Antón Rodrigo, Iván; Ramón Espinoza, Fernanda; Marín Epelde, Itxaso; Sánchez Latorre, Marina; Moral Cuesta, Débora; Casas Herrero, Álvaro; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako GobernuaIntroduction: The World Health Organisation recently defined the construct of intrinsic capacity (IC), a function-based marker of older adult’s health encompassing all mental and physical capacities of the individual. Multicomponent physical exercise (MCE) is a potential intervention capable to maintain/increase IC at older age; however, evidence is scarce on the effects of MCE on IC in cognitively impaired pre-frail/frail older adults. Methods: Secondary analyses of a randomised clinical trial. One hundred and eighty-eight older outpatients (age = 84.06 ± 4.77, 70.2% women) presenting with pre-frailty/frailty (according to Fried Criteria) and mild cognitive impairment (MCI)/mild dementia were recruited in the Geriatric clinics of three tertiary hospitals in Spain. Subjects were randomised to participate in the 12-week home-based individualised Vivifrail MCE or usual care. An IC index was created based on the z-score of the locomotion (Short Physical Performance Battery), cognitive (Montreal Cognitive Assessment), psychology (15-item Geriatric Depression Scale Yesavage) and vitality (handgrip strength) domains. Results: After the 3-month intervention, linear mixed models showed significant between-group differences in the evolution of the IC composite score (β=0.48; 95% confidence interval [CI] = 0.24, 0.74; P < 0.001), IC Locomotion (β = 0.42; 95% CI = 0.10, 0.74; P < 0.001), IC Cognition (β = 0.45; 95% CI = 0.03, 0.87; P < 0.05) and IC Vitality domains (β = 0.50; 95% CI = 0.25, 0.74 at 3-month) favouring the MCE group. Conclusions: The 12-week Vivifrail multicomponent exercise program is an effective strategy to enhance IC, especially in terms of locomotion, cognition and vitality IC domains in community-dwelling older adults with pre-frailty/frailty and MCI/mild dementia, compared to usual care.Publication Open Access Plasma inflammatory biomarkers and anorexia of ageing among community-dwelling older adults: an exploratory analysis of the MAPT Study(Springer, 2023) Sánchez Sánchez, Juan Luis; Guyonnet, Sophie; Lucas, Alexandre; Parini, Angelo; Rolland, Y.; Souto Barreto, Philipe de; Ciencias de la Salud; Osasun ZientziakAnorexia of aging and biological aging might share physiological underpinnings. The aim of this secondary analysis was to investigate the associations between circulating inflammation-related markers and anorexia of aging in community-dwelling older adults. C-reactive protein (CRP), tumor necrosis factor receptor-1 (TNFR-1), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1) and growth/differentiation factor-15 (GDF-15) were measured in plasma. Anorexia of aging was defined by the response “severe/moderate decrease in food intake” to the first item of the Mini-Nutritional Assessment. We included 463 subjects (median age=74y, IQR=71–78; 63.1% women). 33 subjects (7.1%) presented with anorexia at baseline, whereas 25 out of 363 (6.9%) developed it along 1-year follow-up. We found that TNFR1 (OR=1.74, 95%CI=1.27–2.39) and GDF-15 (OR=1.38, 95%CI=1.01–1.89) were associated with a significant increase in the odds of presenting with anorexia of aging cross-sectionally. No further significant associations were found. Biological aging mechanisms might be involved in the pathogenesis of anorexia of aging.Publication Open Access Association of physical behaviours with sarcopenia in older adults: a systematic review and meta-analysis of observational studies(Elsevier, 2024) Sánchez Sánchez, Juan Luis; He, Lingxiao; Morales, Javier S.; Souto Barreto, Philipe de; Jiménez Pavón, David; Carbonell-Baeza, Ana; Casas Herrero, Álvaro; Gallardo-Gómez, Daniel; Lucía, Alejandro; Pozo Cruz, Borja del; Valenzuela, Pedro L.; Ciencias de la Salud; Osasun ZientziakContexto: Los comportamientos físicos (esto es, la actividad física y el comportamiento sedentario) parecen influenciar el desarrollo de la sarcopenia, aunque la evidencia al respecto presenta limitaciones. Este estudio tuvo como objetivo explorar la asociación entre la actividad física total, distintos niveles de intensidad de la actividad física y el comportamiento sedentario, y la sarcopenia y sus componentes (masa muscular, fuerza muscular y función física) en adultos mayores. Métodos: Se llevó a cabo una revisión sistemática y meta-análisis. Se realizó una búsqueda en las bases bibliográficas MEDLINE (vía Pubmed), Scopus y Web of Science hasta el 26 de julio de 2022 para identificar estudios revisados por pares, observacionales (o que utilizasen datos basales de estudios experimentales), que incluyeran adultos mayores (mayores de 60 años, o con medias mayores a 65 años) y publicados en inglés, que reportasen asociaciones entre los niveles de actividad física y/o comportamiento sedentario y la sarcopenia (o sus determinantes: masa muscular, fuerza muscular y función física). Se extrajeron los estimadores individuales y fueron meta-analizados por medio de modelos Bayesianos. Los sesgos de publicación fueron evaluados a través de la prueba de Egger. El estudio fue registrado en PROSPERO previo a su ejecución. Hallazgos: De los 15 766 registros encontrados, 124 (n=230174 adultos mayores, 52.7% mujeres) fueron incluidos en la revisión sistemática. De éstos, 86 pudieron ser incluidos en los meta-análisis. Niveles mayores de actividad física total se asociaron inversamente con la sarcopenia tanto a nivel transversal (21 estudios, n=59 572, razón de momios 0.49, 95% intervalo de credibilidad 0.37-0.62) como longitudinal (cuatro estudios, n=7545, razón de momios 0.51, 0.27-0.94). Además, la actividad física de moderada a vigorosa apuntó a poseer un rol protector frente al riesgo de presentar sarcopenia a nivel transversal (cinco estudios, n=6787, 0.85. 0.71-0.99), mientras que no observamos ninguna asociación para el resto de los comportamientos físicos analizados (número de pasos, actividad física ligera, o comportamiento sedentario). Interpretación: La actividad física total y de moderada a vigorosa se asocian inversamente con la sarcopenia. Estos resultados contribuyen a reforzar la importancia de la actividad física de mayor intensidad, frente a la actividad física ligera o las reducciones en el comportamiento sedentario, en la prevención de la sarcopenia, lo que podría guiar el diseño de intervenciones orientadas a minimizar este síndrome.Publication Open Access Periostin plasma levels and changes on physical and cognitive capacities in community-dwelling older adults(Oxford University Press, 2023) Sánchez Sánchez, Juan Luis; Ader, Isabelle; Jeanson, Yannick; Planat-Benard, Valérie; Vellas, Bruno; Casteilla, Louis; Souto Barreto, Philipe de; Ciencias de la Salud; Osasun ZientziakPeriostin, involved in extracellular matrix development and support, has been shown to be elevated in senescent tissues and fibrotic states, transversal signatures of aging. We aimed to explore associations between plasma periostin and physical and cognitive capacity evolution among older adults. Our hypothesis was that higher levels of plasma periostin will be associated with worse physical and mental capacities along time. Analyses included 1 096 participants (mean age = 75.3 years ± 4.4; 63.9% women) from the Multidomain Alzheimer Preventive Trial. Periostin levels (pg/mL) were measured in plasma collected at year 1. Periostin was used in continuous variable, and as a dichotomous variable highest quartile (POSTN+) versus lowest 3 quartiles (POSTN−) were used. Outcomes were measured annually over 4 years and included: gait speed (GS), short physical performance battery (SPPB) score, 5-times sit-to-stand test (5-STS), and handgrip strength (HS) as physical and cognitive composite z-score (CCS) and the Mini-Mental State Examination (MMSE) as cognitive endpoints. Plasma periostin as a continuous variable was associated with the worsening of physical and cognitive capacities over 4 years of follow-up, specifically the SPPB score, the 5-STS, and CCS in full-adjusted models. POSTN+ was associated with worse evolution in the physical (GS: [β = −0.057, 95% confidence interval (CI) = −0.101, −0.013], SPPB score [β = −0.736, 95% CI = −1.091, −0.381], 5-STS [β = 1.681, 95% CI = 0.801, 2.561]) as well as cognitive (CCS [β = −0.215, 95% CI = −0.335, −0.094]) domains compared to POSTN− group. No association was found with HS or the MMSE score. Our study showed for the first time that increased plasma periostin levels were associated with declines in both physical and cognitive capacities in older adults over a 4-year follow-up. Further research is needed to evaluate whether periostin might be used as a predictive biomarker of functional decline at an older age.