Sarcopenia and mortality among a population‐based sample of community‐dwelling older adults

Abstract

BackgroundSarcopenia is a risk‐factor for all‐cause mortality among older adults, but it is unknown if sarcopenia predisposes older adults to specific causes of death. Further, it is unknown if the prognostic role of sarcopenia differs between males and females, and obese and non‐obese individuals.MethodsA population‐based cohort study among 4425 older adults from the Third National Health and Nutrition Survey (1988–1994). Muscle mass was quantified using bioimpedance analysis, and muscle function was quantified using gait speed. Multivariable‐adjusted Cox regression analysis examined the relationship between sarcopenia and mortality outcomes.ResultsThe mean age of study participants was 70.1 years. The prevalence of sarcopenia was 36.5%. Sarcopenia associated with an increased risk of all‐cause mortality [hazard ratio (HR): 1.29 (95% confidence interval (95% CI): 1.13–1.47); P < 0.001] among males and females. Sarcopenia associated with an increased risk of cardiovascular‐specific mortality among females [HR: 1.61 (95% CI: 1.22–2.12); P = 0.001], but not among males [HR: 1.07 (95% CI: 0.81–1.40; P = .643); P interaction = 0.079]. Sarcopenia was not associated with cancer‐specific mortality among males and females [HR: 1.07 (95% CI: 0.78–1.89); P = 0.672]. Sarcopenia associated with an increased risk of mortality from other causes (i.e. non‐cardiovascular and non‐cancer) among males and females [HR: 1.32 (95% CI: 1.07–1.62); P = 0.008]. Obesity, defined using body mass index (P interaction = 0.817) or waist circumference (P interaction = 0.219) did not modify the relationship between sarcopenia and all‐cause mortality.ConclusionsSarcopenia is a prevalent syndrome that is associated with premature mortality among community‐dwelling older adults. The prognostic value of sarcopenia may vary by cause‐specific mortality and differ between males and females.

The mortality determinants of sarcopenia and comorbidities in hospitalized geriatric patients

“…The 'Low SPPB-scores' group have a fifty percent higher risk compared to the 'High SPPB-scores' group. These data of hospitalized geriatric patients confirm the results of other studies in different populations 4,10,13,15,[21][22][23] . Figure 1 gives an overview of the Kaplan Meier curves of all these significant class variables.…”

“…Later research however, demonstrated that, besides skeletal muscle mass, also muscle strength and/or physical performance were important in the clinical specification of sarcopenia. Since then, a revolution in the concept of the definition of sarcopenia had been set [3][4][5] . Several international research groups, including the European Working Group on Sarcopenia in Older People (EWGSOP), use these three determinants to present their clinical definition for the diagnosis of sarcopenia 6,7 .…”

“…As a result, nowadays, there is still no universal operational definition of sarcopenia [8][9][10] . Sarcopenia is known to be associated with an increased risk for several adverse outcomes such as frailty, hospitalization, disability and mortality 4,13,14 . Especially the determinants muscle mass, muscle strength and physical performance have been found to play a major part in the increased risk of these adverse outcomes 4,5 .…”

“…Sarcopenia is known to be associated with an increased risk for several adverse outcomes such as frailty, hospitalization, disability and mortality 4,13,14 . Especially the determinants muscle mass, muscle strength and physical performance have been found to play a major part in the increased risk of these adverse outcomes 4,5 . Also, sarcopenic patients with a diminished nutritional status have been shown to be at greater risk of dying in the shortterm 15 .…”

Considering technique of assessment and method for normalizing skeletal muscle mass

“…Sarcopenia is defined as loss of skeletal muscle mass accompanied by a reduction in muscle strength or physical performance,1 may be more severe among elderly individuals2 and patients with chronic disease such as those with chronic kidney disease (CKD) 3. There is no consensus regarding operational criteria for sarcopenia in patients with advanced pre‐dialysis CKD or maintenance hemodialysis.…”