Strength measures are better than muscle mass measures in predicting health-related outcomes in older people: time to abandon the term sarcopenia?

Menant, Jasmine C.; Weber, F. Parkes; Lo, Joanne; Sturnieks, Daina L.; Close, Jacqueline C.T.; Sachdev, Perminder S.; Brodaty, Henry; Lord, Stephen R.

doi:10.1007/s00198-016-3691-7

Cited by 118 publications

(93 citation statements)

References 55 publications

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“…It is in line with the existing literature reporting poor association between muscle mass‐based measures of sarcopenia and functional outcomes (i.e. mobility and disability) in the elderly . The present study utilized phase angle, an inspection technique of BIA, which is calculated directly without regression equation.…”

Section: Discussionsupporting

confidence: 62%

Predictivity of bioimpedance phase angle for incident disability in older adults

Uemura

Doi

Tsutsumimoto

et al. 2019

J cachexia sarcopenia muscle

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Background Bioelectrical impedance analysis (BIA)‐derived phase angle is expected to be an efficient prognostic marker of health adverse events with aging as an alternative of muscle mass. We aimed to examine the predictive ability of phase angle for incident disability in community‐dwelling elderly and determine the optimal cut‐off values. Methods Community‐dwelling elderly aged ≥65 years (n = 4452; mean age = 71.8 ± 5.3 years, 48.3% women) without disability at baseline participated in this prospective cohort study. Phase angle and appendicular skeletal muscle mass (ASM) were examined using a multi‐frequency BIA at baseline. Other potential confounding factors (demographics, cognitive function, depressive symptoms, medications, and physical performance) were also assessed. Incident disability was monitored on the basis of long‐term care insurance certification. Results Over a follow‐up of 24 months, 4.0% (n = 174) experienced disability, with an overall incidence rate of 20.6 per 1000 person‐years. The Cox hazard regression analysis showed that phase angle, as a continuous variable, was independently associated with incident disability after adjusting the covariates [male: hazard ratios (HRs) = 0.61, 95% confidence interval (CI) = 0.37–0.98; female: HR = 0.58, 95% CI = 0.37–0.90], although body mass index adjusted ASM was not. Receiver operating characteristic analysis indicated moderate predictive abilities of phase angle for incident disability [male: area under the receiver operating characteristic curve (AUC) = 0.76, 95% CI = 0.70–0.83; female: AUC = 0.71, 95% CI = 0.65–0.76], while those of body mass index adjusted ASM were low (male: AUC = 0.59, 95% CI = 0.521–0.66; female: AUC = 0.58, 95% CI = 0.52–0.63). Multivariate Cox regression analysis showed that low phase angle categorized by cut‐off value (male, ≤4.95°; female, ≤4.35°) was independently related to increased risk of incident disability (HR = 1.95, 95% CI = 1.37–2.78). Conclusions Lower phase angle independently predicts the incident disability separately from known risk factors. BIA‐derived phase angle can be used as a valuable and simple prognostic tool to identify the elderly at risk of disability as targets of preventive treatment.

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Section: Discussionsupporting

confidence: 62%

Predictivity of bioimpedance phase angle for incident disability in older adults

Uemura

Doi

Tsutsumimoto

et al. 2019

J cachexia sarcopenia muscle

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“…Review of the titles and abstracts yielded 241 relevant studies for full‐text screening. Thirty‐six studies met all inclusion criteria and were included in this review . A total of 33 studies were included in the meta‐analysis; four of them presented data for both falls and fractures, leaving 20 studies included in the meta‐analysis for falls and 17 studies for fractures …”

Section: Resultsmentioning

confidence: 99%

“…Four studies included a combined group of hospitalized patients with fractures and community‐dwelling individuals without fractures . Two studies reported retrospective data, 20 studies were cross‐sectional, 13 studies were prospective, and 1 study was a randomized controlled trial examining the effect of nutritional supplementation on bone mineral density and risk of falls . Most of the studies were performed in Europe (12 studies), and Asia (12 studies), followed by Australia (5 studies), South America (4 studies), and North America (3 studies) .…”

Section: Resultsmentioning

confidence: 99%

Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta‐analysis

Yeung

Reijnierse

Pham

et al. 2019

J cachexia sarcopenia muscle

621

463

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Sarcopenia is a potentially modifiable risk factor for falls and fractures in older adults, but the strength of the association between sarcopenia, falls, and fractures is unclear. This study aims to systematically assess the literature and perform a meta‐analysis of the association between sarcopenia with falls and fractures among older adults. A literature search was performed using MEDLINE, EMBASE, Cochrane, and CINAHL from inception to May 2018. Inclusion criteria were the following: published in English, mean/median age ≥ 65 years, sarcopenia diagnosis (based on definitions used by the original studies' authors), falls and/or fractures outcomes, and any study population. Pooled analyses were conducted of the associations of sarcopenia with falls and fractures, expressed in odds ratios (OR) and 95% confidence intervals (CIs). Subgroup analyses were performed by study design, population, sex, sarcopenia definition, continent, and study quality. Heterogeneity was assessed using the I 2 statistics. The search identified 2771 studies. Thirty‐six studies (52 838 individuals, 48.8% females, and mean age of the study populations ranging from 65.0 to 86.7 years) were included in the systematic review. Four studies reported on both falls and fractures. Ten out of 22 studies reported a significantly higher risk of falls in sarcopenic compared with non‐sarcopenic individuals; 11 out of 19 studies showed a significant positive association with fractures. Thirty‐three studies (45 926 individuals) were included in the meta‐analysis. Sarcopenic individuals had a significant higher risk of falls (cross‐sectional studies: OR 1.60; 95% CI 1.37–1.86, P < 0.001, I 2 = 34%; prospective studies: OR 1.89; 95% CI 1.33–2.68, P < 0.001, I 2 = 37%) and fractures (cross‐sectional studies: OR 1.84; 95% CI 1.30–2.62, P = 0.001, I 2 = 91%; prospective studies: OR 1.71; 95% CI 1.44–2.03, P = 0.011, I 2 = 0%) compared with non‐sarcopenic individuals. This was independent of study design, population, sex, sarcopenia definition, continent, and study quality. The positive association between sarcopenia with falls and fractures in older adults strengthens the need to invest in sarcopenia prevention and interventions to evaluate its effect on falls and fractures.

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“…The social domains of frailty might have greater impacts on muscle function and performance than on muscle mass. Muscle strength measures could be better than muscle mass parameters in predicting health‐related outcomes in older people . Results of the present study suggest that interventions to prevent social frailty might be particularly beneficial for community‐dwelling older adults for maintaining physical health.…”

Section: Discussionmentioning

confidence: 99%

Associations of social frailty with loss of muscle mass and muscle weakness among community‐dwelling older adults

Makizako

Kubozono

Kiyama

et al. 2018

Geriatrics Gerontology Int

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Aim The present cross‐sectional study examined the associations of social frailty status with loss of muscle mass and weakness among community‐dwelling older adults. Methods Data from 353 older adults (74.8% women) who had participated in a community‐based health check survey (Tarumizu Study) were analyzed. Social frailty was defined using responses to five questions (going out less frequently, rarely visiting friends, feeling unhelpful to friends or family, living alone and not talking with someone every day). Participants with two or more components were considered socially frail. We assessed appendicular skeletal muscle mass using bioelectrical impedance analysis and calculated appendicular skeletal muscle index. Dominant handgrip strength was assessed. Loss of skeletal muscle mass (appendicular skeletal muscle index <7.0 kg/m2 for men, <5.7 kg/m2 for women) and muscle weakness (handgrip strength <26 kg for men, <18 kg for women) were determined based on the Asian Working Group for Sarcopenia criteria. Results The prevalence of social frailty was 14.7%. A higher prevalence of muscle weakness and loss of skeletal muscle mass in participants with social frailty was shown than in those without (muscle weakness 44.2% vs 23.6%, P ≤ 0.05; loss of skeletal muscle mass 59.6% vs 46.2%, P = 0.07). Social frailty was independently associated with muscle weakness (odds ratio 2.04, 95% confidence interval 1.06–3.95), but not with loss of skeletal muscle mass (odds ratio 1.47, 95% confidence interval 0.78–2.76) after adjusting for covariates. Conclusions Social frailty status could be associated with muscle weakness, though not a loss of skeletal muscle mass. Geriatr Gerontol Int 2019; 19: 76–80.

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Strength measures are better than muscle mass measures in predicting health-related outcomes in older people: time to abandon the term sarcopenia?

Cited by 118 publications

References 55 publications

Predictivity of bioimpedance phase angle for incident disability in older adults

Predictivity of bioimpedance phase angle for incident disability in older adults

Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta‐analysis

Associations of social frailty with loss of muscle mass and muscle weakness among community‐dwelling older adults

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