Operational definitions of sarcopenia should consider depressive symptoms

Abstract

BackgroundOriginally, sarcopenia meant ‘poverty of flesh’, but recent operational definitions have brought poor muscle function to the fore. None has considered psychological well‐being. We compared muscle function components of the European Working Group on Sarcopenia in Older People Version 2 (EWGSOP2), the Foundation for the National Institutes of Health (FNIH), and the Sarcopenia Definitions and Outcomes Consortium (SDOC) algorithms for individuals with and without depressive and anxiety symptoms.MethodsThis cross‐sectional study involved 348 women and 343 men (ages 60–96 years) from the Geelong Osteoporosis Study. Hospital Anxiety and Depression Scale scores for depression and anxiety ≥8 indicated depressive and anxiety symptoms. Measures included handgrip strength (HGS) and Timed Up and Go (TUG). Chi‐squared test identified inter‐group differences, and multivariable logistic regression identified poor muscle function in association with depressive or anxiety symptoms.ResultsTwenty‐nine (8.3%) women and 28 (8.2%) men had depressive symptoms, and 83 (23.9%) women and 41 (12.0%) men had anxiety symptoms. For women, proportions with low HGS were greater for those with vs. without depressive symptoms according to EWGSOP2 and FNIH (37.9% vs. 10.7%) and SDOC (51.7% vs. 26.7%); low HGS/body mass index (44.8% vs. 15.7%); and slow TUG (12.5% vs. 1.4%) (all P ≤ 0.011). In age‐adjusted models, women with depressive symptoms were two‐fold to five‐fold more likely to have low HGS by EWGSOP2 and FNIH {odds ratio [OR] 4.77 [95% confidence interval (CI) 1.83–12.45]} and SDOC [OR 2.59 (95% CI 1.10–6.07)], low HGS/body mass index [OR 3.92 (95% CI 1.69–9.07)], and 11‐fold more likely to have a slow TUG [OR 10.99 (95% CI 2.03–59.7)]. For men, a difference for low HGS for those with depressive symptoms was detected only for SDOC (64.3% vs. 40.0%, P = 0.013), but this was explained by age [OR 1.99 (95% CI 0.84–4.71)]. No differences were detected for anxiety symptoms.ConclusionsOperational definitions should consider depressive symptoms, at least in women, at the time of muscle function evaluation.

Exploring the Association between Elevated Anxiety Symptoms and Low Skeletal Muscle Mass among Asymptomatic Adults: A Population-Based Study in Republic of Korea

“…A 1-SD increase in strength was associated with 12.1% lower odds of GAD coexistence [39]. Previous studies have confirmed the association of increased muscle strength with mental illnesses, such as cognitive decline [10][11][12] and depression [10,13,15,16]. However, despite LMM being primarily implicated in the reduction of muscle contractility [19] and associated with adverse outcomes in chronic diseases [20][21][22][23][24][25], there is no direct evidence confirming its association with anxiety symptoms.…”

“…While sarcopenia has traditionally been thought to be a consequence of aging, recent studies have shown that it is not uncommon in younger individuals because of malnutrition [4], infection, anorexia nervosa [5], diabetes [6] and malignancies [4,6,7]. Sarcopenia in all age groups is associated with more falls and fractures; trouble managing chronic diseases such as cardiovascular diseases, and stroke [6,8];and poor mental health outcomes such as degenerative cognitive disorders [9][10][11][12] or depression [13][14][15][16], resulting in loss of independence, diminished quality of life, hospitalization and mortality [17,18]. Skeletal muscle mass loss mainly attributes to the reduction in contractile force of muscle cells (single myofibrils), rather than qualitative decline, such as changes in myofiber morphology [19].…”

How Well Do Low Population-Specific Values for Muscle Parameters Associate with Indices of Poor Physical Health? Cross-Sectional Data from the Geelong Osteoporosis Study

“…We have reported that prevalence estimates for sarcopenia vary substantially in different geographic areas and also in homogeneous samples when different criteria and cut-off points are applied [ 7 , 8 ]. Nevertheless, despite these differences, sarcopenia and its components have consistently been associated with physical limitations [ 9 ], mental ill-health [ 10 ], and poor cognitive function [ 11 , 12 ].…”