**7. Frail and sarcopenia**

Frail is a state that shows vulnerability to external stress with aging, and is said to be different from the state requiring nursing care. There is no global definition of frailty or diagnostic criteria, but Fried's criteria are widely adopted [30]. It has been pointed out that the onset of frailty is related to the decrease in hormone levels such as sex hormones and vitamin D, nutritional status and nutrient intake, and the relationship between low testosterone status and frailty syndrome, physical function, and fall risk [31]. In addition, a study analyzing the relationship between frailty and urinary incontinence in 300 elderly people in Italy found that elderly people with urinary incontinence were at significantly higher risk of being classified as frailty, and urinary incontinence is a marker of frailty in the elderly [32].

Sarcopenia's pathology is similar to the frailty syndrome and is also a major contributor to the physical frailty syndrome, defined as age-related loss of muscle mass and strength. Frail's phenotype can be broadly divided into five types. That is, malnutrition (weight loss), subjective decreased vitality (easy fatigue), decreased activity, decreased mobility (decreased walking speed), and decreased muscle strength (decreased grip strength). Of these, weakness and weakness are called physical frailty and are elements of sarcopenia. Sarcopenia has been attracting attention in recent years as a cause of bedridden and fall risk in the elderly. The prevalence of sarcopenia is estimated to be approximately 9% in young women and approximately 18% in older men [33]. The causes of sarcopenia are qualitative changes accompanied by functional decline such as fast muscle fiber-specific atrophy, decreased

## *Pelvic Floor Dysfunction - Symptoms, Causes, and Treatment*

fiber count, and connective tissue hyperplasia due to changes in nutritional status, decreased physical activity, and production of inflammatory cytokines.

Eddy currents caused by magnetic stimulation induce contraction of skeletal muscle by causing depolarization of cell membranes of peripheral nerves and skeletal muscle. Electrical stimulation has been widely used in the clinical setting of conventional rehabilitation, but rehabilitation by painless magnetic stimulation is expected in the future. In addition, a study examining the relationship between sarcopenia and ADL in patients with early-stage Alzheimer's suggests that disorientation and sarcopenia may interact to induce functional urinary incontinence. In addition, another study examining the correlation between dysuria and the overall functioning of the elderly found a significant correlation between urinary storage symptoms and the Barthel Index, suggesting that improvement in dysuria leads to improvement in symptoms, including sarcopenia. From these reports, magnetic therapy is expected to improve muscle mass and dysuria in sarcopenia patients, and may be a breakthrough non-invasive therapy in our aging society.
