1. Prevalence of sarcopenia among Slovenian older adults and associated risk factorsKatarina Puš, Saša Pišot, Uroš Marušič, Manca Peskar, Kaja Teraž, Miloš Kalc, Helena Blažun Vošner, Peter Kokol, Jernej Završnik, Boštjan Šimunič, 2025, izvirni znanstveni članek Povzetek: Introduction: Sarcopenia is a multifaceted condition affecting between 10 and 16% of the global population, and although multiple classification algorithms exist, no prevalence has been reported for a representative sample of the Slovenian population. Furthermore, multiple behavioural factors, such as malnutrition, physical inactivity, sedentary lifestyle and lower cognitive function, can contribute to the risk of sarcopenia. This study aims to: a) determine sarcopenia prevalence among Slovenian older adults according to different classification algorithms, b) compare the agreement among the algorithms and c) evaluate the relationship between proposed risk factors and sarcopenia. Methods: 654 participants (≥60 years, 30.4% males) have been classified into sarcopenia groups according to eight algorithms, and agreement (Fleiss K) between them was calculated. Additionally, age, sex, nutritional status, physical activity, sedentary levels and cognitive function were assessed as sarcopenia risk/protective factors. Results: The prevalence of sarcopenia according to EWGSOP2 was 4.1%, ranging from 2.1% to 15.3%, when classified by all eight algorithms. Overall agreement between algorithms was weak (K=.429; 95% CI .414 to .444) with 0.6% of participants classified as sarcopenic by all eight algorithms. Adequate nutrition and physical activity were identified as protective factors, while age, lower cognitive function and sedentary lifestyle were considered risk factors. Conclusion: Sarcopenia prevalence among the Slovenian general population was lower than in the global population. We can conclude that different sarcopenia algorithms lead to a different prevalence of sarcopenia. It is of great importance to be cautious when comparing prevalences among studies and to further validate the classification algorithms. Ključne besede: sarcopenia, prevalence, epidemiology, classification algorithms, risk factors Objavljeno v DiRROS: 03.03.2025; Ogledov: 247; Prenosov: 120
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2. Post-physical therapy 4-month in-home dynamic standing protocol maintains physical therapy gains and improves mobility, balance confidence, fear of falling and quality of life in Parkinson’s disease : a randomized controlled examiner-blinded feasibility clinical trialMiriam van Emde Boas, Chatkaew Pongmala, Abigail M. Biddix, Alexis Griggs, Austin T. Luker, Giulia Carli, Uroš Marušič, Nicolaas I. Bohnen, 2024, izvirni znanstveni članek Povzetek: Objective: Parkinson’s patients will experience mobility disturbances with disease progression. Beneficial effects of physical therapy are short-lasting. Novel interventions are needed to maintain these benefits. Methods: Fourteen Parkinson’s patients (71±4.08 years) participated in a randomized controlled examiner-blinded feasibility clinical trial. After 12 physical therapy sessions, the intervention group received a height-adjustable desk that facilitates stepping while standing, for 4 months. Explorative outcome measures included MDS-UPDRS II, III, TUG, 8.5m walking test, PDQ-39, sABC, sFES, DEXA scans, and lower extremity strength. Results: Post-physical-therapy, everyone significantly improved on the MDS-UPDRS II, III, TUG, and 8.5m walking test, and PDQ-39. (p<0.05) After 4 months, the control group regressed towards pre-physical-therapy values. In the intervention group, sedentary behavior decreased beyond desk use, indicating a carry-over effect. MDS-UPDRS II, PDQ-39, sFES, sABC, TUG, 8.5m walking test, activity time, sitting time, hip strength all improved with clinically relevant effect sizes. Conclusion: Postphysical therapy in-home reduction of sedentary behavior was associated with maintenance of physical benefits and additional improvements in mobility, activity time, balance and quality of life Ključne besede: Parkinson’s disease, physical therapy, sedentarism, sarcopenia, quality of life Objavljeno v DiRROS: 05.12.2024; Ogledov: 328; Prenosov: 173
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3. The abdominal adiposity index (a body shape index) predicts 10-year all-cause mortality in elderly active non-obese subjectsAlessio Nunnari, Filippo Giorgio Di Girolamo, Kaja Teraž, Nicola Fiotti, Boštjan Šimunič, Filippo Mearelli, Rado Pišot, Gianni Biolo, 2024, izvirni znanstveni članek Povzetek: Background/Objectives: A Body Shape Index (ABSI), which accounts for waist circumference relative to mass and height, shows a robust association with mortality risk. The present study evaluates the effectiveness of ABSI as a predictor of 10-year all-cause mortality in physically active, non-obese elderly individuals. Methods: This prospective cohort study included 159 volunteers (94 women, aged 60–80 years), recruited in the frame of the “Physical Activity and Nutrition for Great Ageing” (PANGeA) Cross-border Cooperation Program Slovenia–Italy 2007–2013, and followed for 10 years. Baseline characteristics included anthropometric measurements, bioelectrical impedance analysis, and cardiovascular fitness tests (VO2max). Statistical analyses (Cox regression, Kaplan–Meier survival) were conducted to examine the relationship between ABSI and mortality. Results: During the 10-year follow-up, 10 deaths (6.7%) were recorded. ABSI (adjusted for age, smoking, comorbidities, and therapy) was an independent predictor of mortality (hazard ratio = 4.65, p < 0.001). Higher ABSI scores were linked to reduced VO2max (r = −0.190, p = 0.017) and increased systolic blood pressure (r = 0.262, p = 0.001). An ABSI-based predictive model showed strong discriminatory power (AUROC = 0.91). Conclusions: ABSI is a reliable predictor of 10-year mortality in active, non-obese elderly individuals and may improve risk stratification in clinical practice. Ključne besede: ABSI, a body shape index, body shape, fre fat mass, sarcopenia, prognostic index, elderly, mortality Objavljeno v DiRROS: 16.10.2024; Ogledov: 682; Prenosov: 469
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4. Sarcopenia and myosteatosis at presentation adversely affect survival after esophagectomy for esophageal cancerMatevž Srpčič, Taja Jordan, Karteek Popuri, Mihael Sok, 2020, izvirni znanstveni članek Ključne besede: esophageal cancer, esophagectomy, muscle depletion, myosteatosis, sarcopenia, survival Objavljeno v DiRROS: 12.07.2024; Ogledov: 560; Prenosov: 195
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5. Neuromuscular component of muscle quality assessment in older adults : narrative reviewKatarina Puš, Boštjan Šimunič, 2024, pregledni znanstveni članek Povzetek: The concept of muscle quality encompasses both microand macroscopic aspects of muscle architecture and composition and has gained increasing attention with inclusion in the definition of sarcopenia, indicating the significance of muscle quality in evaluating muscle function and strength among older individuals. Muscle quality consists of two main components: neuromuscular and morphological and is often defined as the ratio between the two. The aim of this review is to present currently used methods for assessment of muscle quality with an emphasis on neuromuscular component in older adults. The most used methods for assessing morphological component are imaging techniques, such as magnetic resonance imaging, computed tomography, dualenergy X-ray absorptiometry and non-imaging bioimpedance analysis. In the neuromuscular component upper and lower body strength are assessed with different methods such as hand grip strength, isokinetic lower limb strength and isometric lower limb strength. Currently, there are three proposed muscle quality assessment methods for field or population studies: muscle quality index, ultrasound sarcopenia index and bioimpedancederived phase angle. Despite the exploration of muscle quality through various assessment methods, a consensus on the most appropriate and universally applicable approach has yet to be established. Ključne besede: ageing, skeletal muscle, ultrasound sarcopenia index, muscle quality index, phase angle Objavljeno v DiRROS: 13.05.2024; Ogledov: 726; Prenosov: 353
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6. Effects of a 2-year exercise training on neuromuscular system health in older individuals with low muscle functionElena Monti, Sara Tagliaferri, Sandra Zampieri, Fabio Sarto, Giuseppe Sirago, Martino V. Franchi, Andrea Ticinesi, Yari Longobucco, Elisa Adorni, Marco Vincenzo Narici, 2023, izvirni znanstveni članek Ključne besede: skeletal muscles, C-terminal agrin fragment, neurofilament light chain, exercise interventions, sarcopenia, elderly Objavljeno v DiRROS: 15.12.2023; Ogledov: 1068; Prenosov: 444
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7. Sarcopenia parameters in active older adults – an eight-year longitudinal studyKaja Teraž, Uroš Marušič, Miloš Kalc, Boštjan Šimunič, Primož Pori, Bruno Grassi, Stefano Lazzer, Marco Vincenzo Narici, Mojca Gabrijelčič Blenkuš, Pietro Enrico Di Prampero, Carlo Reggiani, Angelina Passaro, Gianni Biolo, Mladen Gasparini, Rado Pišot, 2023, izvirni znanstveni članek Povzetek: Background Sarcopenia is a common skeletal muscle syndrome that is common in older adults but can be mitigated by adequate and regular physical activity. The development and severity of sarcopenia is favored by several factors, the most influential of which are a sedentary lifestyle and physical inactivity. The aim of this observational longitudinal cohort study was to evaluate changes in sarcopenia parameters, based on the EWGSOP2 definition in a population of active older adults after eight years. It was hypothesized that selected active older adults would perform better on sarcopenia tests than the average population. Methods The 52 active older adults (22 men and 30 women, mean age: 68.4±5.6 years at the time of their first evaluation) participated in the study at two time points eight-years apart. Three sarcopenia parameters were assessed at both time points: Muscle strength (handgrip test), skeletal muscle mass index, and physical performance (gait speed), these parameters were used to diagnose sarcop0enia according to the EWGSOP2 definition. Additional motor tests were also performed at follow-up measurements to assess participants’ overall fitness. Participants self-reported physical activity and sedentary behavior using General Physical Activity Questionnaire at baseline and at follow-up measurements. Results In the first measurements we did not detect signs of sarcopenia in any individual, but after 8 years, we detected signs of sarcopenia in 7 participants. After eight years, we detected decline in ; muscle strength (-10.2%; p<.001), muscle mass index (-5.4%; p<.001), and physical performance measured with gait speed (-28.6%; p<.001). Similarly, self-reported physical activity and sedentary behavior declined, too (-25.0%; p=.030 and −48.5%; p<.001, respectively). Conclusions Despite expected lower scores on tests of sarcopenia parameters due to age-related decline, participants performed better on motor tests than reported in similar studies. Nevertheless, the prevalence of sarcopenia was consistent with most of the published literature. Trial registration The clinical trial protocol was registered on ClinicalTrials.gov, identifier: NCT04899531 Ključne besede: elderly, physical activities, sedentary behavior, skeletal muscle disorder, sarcopenia Objavljeno v DiRROS: 29.05.2023; Ogledov: 961; Prenosov: 517
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8. Sarcopenia, obesity, and their association with selected behavioral factors in active older adultsKaja Teraž, Miloš Kalc, Manca Peskar, Saša Pišot, Boštjan Šimunič, Rado Pišot, Primož Pori, 2023, izvirni znanstveni članek Povzetek: Introduction: The number of obese people in the world is increasing, as is the number of sarcopenic people among the older adults. Although both states are concerning, they can be positively influenced by selected behavioral factors such as adequate nutrition and physical activity. We were interested in the prevalence of sarcopenic obesity in active older people and the influence of behavioral factors on this phenomenon. Methods: The study included 38 older adults (21 women) with a mean age of 75.3 ± 5.0 years. Sarcopenic parameters were determined with different tests: Handgrip Test, Chair Stand Test, Gait Speed, Timed Up and Go Test, and Short Physical Performance Battery. Body composition was measured by dual-energy x-ray absorptiometry. Physical activity level was measured using accelerometers, and nutritional status was assessed using the Mini-Nutritional Assessment and MEDLIFE Index questionnaire. Results: Of all included active participants (the average number of steps per day was 8,916 ± 3,543), 47.4% of them were obese. Of all included women, 52.4% were obese. Sarcopenic obesity was found in three (7.9%) participants. Nutritional status correlated with strength of lower extremities and physical performance tests (gait speed, Timed Up and Go Test and Short Physical performance battery). Higher number of steps per day positively correlates with physical performance. Discussion: Interestingly, we did not find any correlation between the main obesity parameter such as percent body fat or body mass index (and thus sarcopenic obesity) and any of the selected behavioral factors (physical activity, sedentary behavior, or dietary habits). In conclusion, reaching the recommended levels of physical activity in older adults may not be sufficient to prevent the occurrence of obesity and sarcopenic obesity. Ključne besede: aging, physical activity, nutrition, healthy lifestyle, body composition, sarcopenia Objavljeno v DiRROS: 02.03.2023; Ogledov: 1265; Prenosov: 619
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9. Irisin attenuates muscle impairment during bed rest through muscle-adipose tissue crosstalkAndrea D'Amuri, Juana Maria Sanz, Stefano Lazzer, Rado Pišot, Boštjan Šimunič, Gianni Biolo, Giovanni Zuliani, Mladen Gasparini, Marco Vincenzo Narici, Bruno Grassi, Carlo Reggiani, Edoardo Dalla Nora, Angelina Passaro, 2022, izvirni znanstveni članek Povzetek: Simple Summary: Irisin is a known myokine secreted mainly by the muscle that is produced after physical activity. It induces browning in the adipose tissue with a consequent increase in mitochondrial oxidation of lipids and reduction of insulin resistance; thus, it has been hypothesized that irisin was the molecule mediating most of the beneficial effects related to exercise on adipose tissue and consequently on the whole organism. In our study we observed that extreme physical inactivity induces the loss of muscle mass and function, and an increase in the body adipose tissue as expected. However, of note, circulating irisin levels were increased secondary to enhanced irisin synthesis mainly from adipose tissue rather than muscle. In addition, subjects who produced more irisin had reduced muscle impairment. Therefore, our hypothesis is that there is negative feedback within the muscle-adipose tissue crosstalk, specifically not only does the muscle influence the adipose tissue through irisin during exercise, but also the adipose tissue protects the muscle during inactivity.Abstract: The detrimental effect of physical inactivity on muscle characteristics are well known. Irisin, an exercise-induced myokine cleaved from membrane protein fibronectin type III domain-containing protein-5 (FNDC5), mediates at least partially the metabolic benefits of exercise. This study aimed to assess the interplay between prolonged inactivity, circulating irisin, muscle performance, muscle fibers characteristics, as well as the FNDC5 gene expression (FNDC5ge) in muscle and adipose tissue among healthy subjects. Twenty-three healthy volunteers were tested before and after 14 days of Bed Rest, (BR). Post-BR circulating levels of irisin significantly increased, whereas body composition, muscle performance, and muscle fiber characteristics deteriorated. Among the subjects achieving the highest post-BR increase of irisin, the lowest reduction in maximal voluntary contraction and specific force of Fiber Slow/1, the highest increase of FNDC5ge in adipose tissue, and no variation of FNDC5ge in skeletal muscle were recorded. Subjects who had the highest FNDC5ge in adipose tissue but not in muscle tissue showed the highest circulating irisin levels and could better withstand the harmful effect of BR. Ključne besede: physical inactivity, bed rest, FNDC5 gene expression, myokines, sarcopenia, muscles fiber Objavljeno v DiRROS: 07.07.2022; Ogledov: 1532; Prenosov: 864
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