IMPORTANCE: Sarcopenia and obesity are 2 global concerns associated with adverse health outcomes in older people. Evidence on the population-based prevalence of the combination of sarcopenia with obesity (sarcopenic obesity [SO]) and its association with mortality are still limited.OBJECTIVE: To investigate the prevalence of sarcopenia and SO and their association with all-cause mortality.DESIGN, SETTING, AND PARTICIPANTS: This large-scale, population-based cohort study assessed participants from the Rotterdam Study from March 1, 2009, to June 1, 2014. Associations of sarcopenia and SO with all-cause mortality were studied using Kaplan-Meier curves, Cox proportional hazards regression, and accelerated failure time models fitted for sex, age, and body mass index (BMI). Data analysis was performed from January 1 to April 1, 2023.EXPOSURES: The prevalence of sarcopenia and SO, measured based on handgrip strength and body composition (BC) (dual-energy x-ray absorptiometry) as recommended by current consensus criteria, with probable sarcopenia defined as having low handgrip strength and confirmed sarcopenia and SO defined as altered BC (high fat percentage and/or low appendicular skeletal muscle index) in addition to low handgrip strength.MAIN OUTCOME AND MEASURE: The primary outcome was all-cause mortality, collected using linked mortality data from general practitioners and the central municipal records, until October 2022.RESULTS: In the total population of 5888 participants (mean [SD] age, 69.5 [9.1] years; mean [SD] BMI, 27.5 [4.3]; 3343 [56.8%] female), 653 (11.1%; 95% CI, 10.3%-11.9%) had probable sarcopenia and 127 (2.2%; 95% CI, 1.8%-2.6%) had confirmed sarcopenia. Sarcopenic obesity with 1 altered component of BC was present in 295 participants (5.0%; 95% CI, 4.4%-5.6%) and with 2 altered components in 44 participants (0.8%; 95% CI, 0.6%-1.0%). An increased risk of all-cause mortality was observed in participants with probable sarcopenia (hazard ratio [HR], 1.29; 95% CI, 1.14-1.47) and confirmed sarcopenia (HR, 1.93; 95% CI, 1.53-2.43). Participants with SO plus 1 altered component of BC (HR, 1.94; 95% CI, 1.60-2.33]) or 2 altered components of BC (HR, 2.84; 95% CI, 1.97-4.11) had a higher risk of mortality than those without SO. Similar results for SO were obtained for participants with a BMI of 27 or greater.CONCLUSIONS AND RELEVANCE: In this study, sarcopenia and SO were found to be prevalent phenotypes in older people and were associated with all-cause mortality. Additional alterations of BC amplified this risk independently of age, sex, and BMI. The use of low muscle strength as a first step of both diagnoses may allow for early identification of individuals at risk for premature mortality.
Constante vernieuwingen op het gebied van digitale technologie in zowel prive- als publieke omgevingen kenmerken de huidige samenlevingen en benadrukken de alsmaar belangrijker wordende rol daarin voor socio-technische systemen. De uitdaging is om voorafgaand, tijdens en na de ontwikkeling van deze systemen de mens en zijn digitale, sociale en fysieke omgeving centraal te blijven stellen. Dit vraagt om een duidelijk inzicht in de behoeften, wensen en eisen van mensen, zodat deze vertaald kunnen worden naar digitale technologie die een positieve bijdrage levert aan gezondheid, welzijn en participatie. Toegepast onderzoek naar het ontwerp- en appropriatieproces van digitale technologie voor maatschappelijk welbevinden is nodig om succesvol gebruik, implementatie, evaluatie en opschaling te bevorderen. Een goede samenwerking en beter begrip van elkaars doelen, motieven en werkwijzen, tussen zowel ontwerpers en gebruikers als tussen onderzoek, onderwijs en het werkveld, zijn hiervoor absolute vereisten. Lector Digital Life dr. Somaya Ben Allouch pleit in haar rede voor meer aandacht voor een mensgerichte ontwerpaanpak van digitale technologie. Het onderzoek van het lectoraat richt zich op innovatieve, digitale technologie op het gebied van mens-systeem interactie, sensoren en hun data en creatieve methodes voor gezondheid, welzijn en participatie. In de rede zal nader worden ingegaan op hoe het onderzoek van het lectoraat Digital Life bijdraagt aan het (inter)nationale netwerk van onderzoek, onderwijs en praktijk op het snijvlak van technologie, gezondheid en welzijn.
The use of growth monitoring and promotion (GMP) has become widespread. It is a potential contributor towards achieving the Millennium Development Goals of halving hunger and reducing child mortality by two-thirds within 2015. Yet, GMP appears to be a prerequisite for good child health but several studies have shown that there is a discrepancy between the purpose and the practice of GMP. The high prevalence of malnutrition in many developing countries seems to confirm this fact. A descriptive qualitative study was carried out from April to September 2011. Focus group discussions and in-depth interviews were conducted amongst mothers and health workers. Data were analyzed using a qualitative content analysis technique, with the support of ATLAS.ti 5.0 software. The results suggest that most mothers were aware of the need for regular weight monitoring while health workers also seemed to be well-aware and to practise GMP according to the international guidelines. However, there was a deficit in maternal knowledge with regard to child-feeding and a lack of basic resources to keep and/or to buy healthful and nutritionally-rich food. Furthermore, the role of the husband was not always supportive of proper child-feeding. In general, GMP is unlikely to succeed if mothers lack awareness of proper child-feeding practices, and if they are not supported by their husbands.