In 2010, the definition of cachexia was jointly developed by the European Society for Clinical Nutrition and Metabolism (ESPEN) Special Interest Groups (SIG) "Cachexia-anorexia in chronic wasting diseases" and "Nutrition in geriatrics". Cachexia was considered as a synonym of disease-related malnutrition (DRM) with inflammation by the ESPEN guidelines on definitions and terminology of clinical nutrition. Starting from these concepts and taking into account the available evidence the SIG "Cachexia-anorexia in chronic wasting diseases" conducted several meetings throughout 2020-2022 to discuss the similarities and differences between cachexia and DRM, the role of inflammation in DRM, and how it can be assessed. Moreover, in line with the Global Leadership Initiative on Malnutrition (GLIM) framework, in the future the SIG proposes to develop a prediction score to quantify the individual and combined effect(s) of multiple muscle and fat catabolic mechanisms, reduced food intake or assimilation and inflammation, which variably contribute to the cachectic/malnourished phenotype. This DRM/cachexia risk prediction score could consider the factors related to the direct mechanisms of muscle catabolism separately from those related to the reduction of nutrient intake and assimilation. Novel perspectives in the field of DRM with inflammation and cachexia were identified and described in the report.
DOCUMENT
BACKGROUND: Preventing metabolic syndrome (MetS) and frailty in older adults is crucial for healthy aging. The association between MetS and physical frailty is well-documented, with low-grade inflammation as potential explanation. However, the association between MetS and frailty as a multidimensional concept, and the association of low-grade inflammation with presence of MetS and frailty, is yet unclear. Therefore, we examined these associations low-grade inflammation in a large cohort of community-dwelling older adults.METHODS: This cross-sectional study was performed among adults aged ≥ 65 years enrolled in the Dutch Lifelines population cohort. MetS was defined according to the Joint Interim Statement of 2009. Frailty was measured by the Groningen Frailty Indicator (GFI), which consists of 15 self-reported items on both physical and psychosocial functioning, with a score ≥ 4 indicating presence of frailty. The association between MetS and its five components and frailty was assessed using logistic regression models. Low-grade inflammation was represented by high-sensitivity C-reactive protein (hsCRP) level. The association of hsCRP level with presence of MetS and frailty was assessed using multinomial logistic regression in a sub-cohort with available hsCRP measurements.RESULTS: Of 11,552 adults (52.1% women) included, the prevalences of MetS and frailty were 28% and 15%, respectively. MetS was positively associated with frailty after adjusting for relevant covariates (OR: 1.37; 95% CI: 1.22-1.53). MetS components elevated blood pressure was most strongly associated with frailty. In the sub-cohort of 3896 participants, high hsCRP was associated with presence of MetS and frailty (OR: 1.31; 95% CI: 1.15-1.51), and MetS alone (OR: 1.44; 95% CI: 1.33-1.56), but not to frailty alone. A higher hsCRP level was associated with a higher score on the physical domain of frailty (b: 0.06; 95% CI: 0.03-0.08).CONCLUSIONS: Presence of MetS is associated with presence of frailty indicated by a multidimensional index in a large group of Dutch older adults. Low-grade inflammation, indicated by plasma hsCRP level, was found to be associated with both presence of MetS and frailty and presence of MetS alone. Increased hsCRP levels were associated with the physical component of frailty, but not with frailty as a multidimensional concept.
DOCUMENT
Background & aims: The Global Leadership Initiative on Malnutrition (GLIM) approach to malnutrition diagnosis is based on assessment of three phenotypic (weight loss, low body mass index, and reduced skeletal muscle mass) and two etiologic (reduced food intake/assimilation and disease burden/inflammation) criteria, with diagnosis confirmed by fulfillment of any combination of at least one phenotypic and at least one etiologic criterion. The original GLIM description provided limited guidance regarding assessment of inflammation and this has been a factor impeding further implementation of the GLIM criteria. We now seek to provide practical guidance for assessment of inflammation in support of the etiologic criterion for inflammation. Methods: A GLIM-constituted working group with 36 participants developed consensus-based guidance through a modified-Delphi review. A multi-round review and revision process served to develop seven guidance statements. Results: The final round of review was highly favorable with 99 % overall “agree” or “strongly agree” responses. The presence of acute or chronic disease, infection or injury that is usually associated with inflammatory activity may be used to fulfill the GLIM disease burden/inflammation criterion, without the need for laboratory confirmation. However, we recommend that recognition of underlying medical conditions commonly associated with inflammation be supported by C-reactive protein (CRP) measurements when the contribution of inflammatory components is uncertain. Interpretation of CRP requires that consideration be given to the method, reference values, and units (mg/dL or mg/L) for the clinical laboratory that is being used. Conclusion: Confirmation of inflammation should be guided by clinical judgement based upon underlying diagnosis or condition, clinical signs, or CRP.
DOCUMENT
De samenwerking tussen de onderzoeksgroep FRIA van de Vrije Universiteit Brussel, afdeling oudergeneeskunde van het UMCG Groningen en de onderzoeksgroep (lectoraat) Healthy Ageing, Allied health Care and Nursing van de Hanzehogeschool Groningen is gericht op onderzoek naar bewegingsstoornissen bij veroudering. In het bijzonder wordt gekeken naar paratonic, een bewegingsstoornis bij dementie.The International Joint Research group ‘Move in Age’ concluded in a systematic review that paratonia still is a barely understood and devastating phenomenon in dementia and revealed the urgency of gaining more insight in the pathophysiology. Paratonia, a distinctive change in muscle tone, starts in early stages of dementia and develops further with progress of the disease. Resulting in severe discomfort for patients, but also affecting caregivers since daily care becomes increasingly difficult. It is hypothesized that changes in motor control due to dementia influences peripheral neurological control and biomechanical muscle structures (by crosslinking and inflammation caused by advanced glycation end-products (AGEs).This IJRG started in 2018 and aims to develop a long-term comprehensive research program on movement-related impairments at higher age. The three partners have a strong track record on research in the area of movement-related impairments in older persons; however, each focusing on a specific aspect. In fact, the Frailty in Ageing research group (FRIA) of the Vrije Universiteit Brussel (VUB) is running focused research program on the triad sarcopenia-dynapenia-inflammation with mainly a bio-gerontological and bio-psycho-medical approach; the department of General Practice and Elderly Care Medicine of the University Medical Center Groningen (UMCG) has anongoing research line on the medical aspects of mobility impairments in frail elderly persons and in elderly dementia patients; and finally Research Group Healthy Ageing, Allied Health Care and Nursing of the Hanze University of Applied Sciences Groningen (HUAS) developed a research program on physical, psycho-cognitive and social dimensions of frailty including the functional impact of mobility impairments. In the first 3-5 years, the focus will be on the movement-related impairments that occur in patients with dementia and in specific on paranoia. The programme will be extended towards movement-related impairments in the context of other geriatric syndromes.
Door de transitie naar een biobased en circulaire economie neemt de behoefte aan biomassa als bron van grondstoffen en chemicaliën toe. De teelt van vezelhennep staat daarom opnieuw in de belangstelling vanwege de veelzijdigheid van het gewas. De vezels uit de stengel worden bijvoorbeeld gebruikt voor textieltoepassingen en plantinhoudsstoffen uit de bladeren en bloemen (o.a. Cannabidiol (CBD)) worden gebruikt als voedingssupplement vanwege de gezondheidsbevorderende eigenschappen. Echter, vezelhennep bevat, naast het bekende CBD, nog een veel breder scala aan plantinhoudsstoffen waaraan gezondheidsbevorderende effecten worden toegeschreven. Afhankelijk van het productie/extractieproces en de gebruikte cultivars komen de andere plantinhoudsstoffen in meer of mindere mate in de producten terecht. Vanuit de producenten van vezelhennep extracten is er vraag naar betere karakterisatie van hun extracten en er is behoefte aan meer kennis over de gezondheidseffecten van de extracten zodat de toepasbaarheid vergroot kan worden. Het doel van dit project is dan ook om een relatie te leggen tussen samenstelling aan secundaire plantinhoudsstoffen van verschillende vezelhennepextracten en de gezondheidseffecten van deze extracten. Om dit doel te bereiken zal er onderzoek gedaan worden naar de invloed van verschillende extractiemethodes, cultivars en bewaarmethodes op de samenstelling aan plantinhoudsstoffen en zal een nieuwe methode voor het verkrijgen van plantinhoudsstoffen doorontwikkeld worden. Deze extracten worden vervolgens getest op hun effecten op de humane gezondheid middels een unieke combinatie aan modelsystemen om de relatie te kunnen leggen met specifieke samenstelling. Veroudering is hier als overkoepeld thema gekozen, omdat het in de vergrijzende samenleving steeds relevanter wordt om gezonder oud te worden. Als subthema’s is gekozen voor afweerfunctie, neuro-inflammatie en spierfunctie. De resultaten zullen worden toegepast om nieuwe, beter gekarakteriseerde extracten op de markt te kunnen brengen. Tevens is dit project, door het multidisciplinaire karakter, uitermate geschikt om een hybride leeromgeving te ontwikkelen waarin studenten worden geleerd om multidisciplinair te werken.
Especially during the summer period, a significant amount of the population experience a health issues caused by the stinging hair of oak-caterpillars. These health complaints are often caused by the skin irritation and allergic reaction when the stinging hair comes in contact with the skin. Additional complaints include swelling and inflammation problems on eyes and throats. The health complaints range from simple itching to serious allergic reactions that can last weeks. Currently, the oak-caterpillars are removed using manual labor, which is labor intensive and time consuming. Cranes are often deployed to reach to various parts of a tree for inspection and combat, which is a slow and an expensive process. In general, since inspection of oak-caterpillars is done with bare eyes of the professionals and detection often occurs at a later stage, significant number of people are affected already. Therefore, a new effective combating methodology is needed. The main goal of this project is to conduct feasibility study of the applicability of semi-autonomous aerial robots (drones) for early stage detection and combat against oak-caterpillars. This innovative solution aspires to use smart aerial robots that employ AI-based techniques for early phase and real-time detection of oak-caterpillars. Once the oak-caterpillars are detected, a direct and selective combating resources will be applied. Within this project, the first proof-of-concepts will be developed. The results of this project will be used to expand the existing network and formulate a bigger project to address additional critical aspects in order to develop a complete oak-caterpillar combating drone. The project will be executed with Research Group of Mechatronics at Saxion, together with the participating innovative SMEs (DronExperts,Drone4Agro). The project will be facilitated by the Municipality of Enschede with respect to polices and the Space53 cluster for networking and testing in operational environments.