Osteoporosis International

, Volume 24, Issue 3, pp 787–796

Sarcopenia and osteopenia among 70–80-year-old home-dwelling Finnish women: prevalence and association with functional performance

  • R. Patil
  • K. Uusi-Rasi
  • M. Pasanen
  • P. Kannus
  • S. Karinkanta
  • H. Sievänen
Original Article

Abstract

Summary

This study showed that the prevalence of sarcopenia (low muscle mass and performance) among 70–80-year-old home-dwelling Finnish women is very low, while every third woman has WHO-based osteopenia (low bone mass). Muscle mass and derived indices of sarcopenia were not significantly related to measures of functional ability.

Introduction

This study aims to determine the prevalence of sarcopenia and osteopenia among four hundred nine 70–80-year-old independently living Finnish women. The study compared consensus diagnostic criteria for age-related sarcopenia recently published by the European Working Group on Sarcopenia in Older People (EWGSOP) and the International Working Group on Sarcopenia (IWG) and assessed their associations with functional ability.

Methods

Femoral bone mineral density and body composition were measured with dual-energy X-ray absorptiometry. Skeletal muscle mass index (SMI), gait speed, and handgrip strength were used for sarcopenia diagnosis. Independent samples t tests determined group differences in body composition and functional ability according to recommended diagnostic cutpoints. Scatter plots were used to illustrate the correlations between the outcome measures used for diagnosis.

Results

Prevalence of sarcopenia was 0.9 and 2.7 % according to the EWGSOP and IWG, respectively. Thirty-six percent of the women had WHO-based osteopenia. Women with higher gait speed had significantly lower body weight and fat mass percentage, higher lean mass percentage, and better functional ability. Women with a low SMI weighed significantly less, with no significant differences in other outcome measures. SMI, gait speed, and grip strength were significantly correlated.

Conclusions

Our study suggests that when using consensus definitions, sarcopenia is infrequent among older home-dwelling women while every third woman has osteopenia. In clinical practice, attention should be paid to the decline in functional ability rather than focusing on low muscle mass alone.

Keywords

Aging Functional ability Osteopenia Sarcopenia 

References

  1. 1.
    Frontera W, Hughes V, Fielding R, Fiatarone M, Ewans W, Roubenoff R (2000) Aging of skeletal muscle: a 12-year longitudinal study. J Appl Physiol 88:1321–1326PubMedGoogle Scholar
  2. 2.
    Kanis J, McCloskey E, Johansson H, Oden A, Melton L 3rd, Khaltaev N (2008) A reference standard for the description of osteoporosis. Bone 42:467–475PubMedCrossRefGoogle Scholar
  3. 3.
    Baumgartner R, Stauber P, McHugh D, Koehler K, Garry P (1995) Cross-sectional age differences in body composition in persons 60+ years of age. J Gerontol A Biol Sci Med Sci 50(6):M307–M316PubMedCrossRefGoogle Scholar
  4. 4.
    Gallagher D, Visser M, DeMeersman R, Sepúlveda D, Baumgartner R, Pierson R, Harris T, Heymsfield S (1997) Appendicular skeletal muscle mass: effects of age, gender and ethnicity. J Appl Physiol 83(1):229–239PubMedGoogle Scholar
  5. 5.
    Fielding R, Vellas B, Evans W, Bhasin S, Morley J, Newman A, Abellan van Kan G, Andrieu S, Bauer J, Breuille D, Cederholm T, Chandler J, De Meynard C, Donini L, Harris T, Kannt A, Keime Guibert F, Onder G, Papanicolaou D, Rolland Y, Rooks D, Sieber C, Souhami E, Verlaan S, Zamboni M (2011) Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International Working Group on Sarcopenia. J Am Med Dir Assoc 12:249–256PubMedCrossRefGoogle Scholar
  6. 6.
    Baumgartner R, Koehler K, Gallagher D, Romero L, Heymsfield S, Ross R, Garry P, Lindeman R (1998) Am J Epidemiol 147(8):755–763PubMedCrossRefGoogle Scholar
  7. 7.
    Newman A, Kupelian V, Visser M, Simonsick E, Goodpaster B, Nevitt M, Kritchevsky S, Tylavsky F, Rubin S, Harris T (2003) Sarcopenia: alternative definitions and associations with lower extremity function. J Am Geriatr Soc 51:1602–1609PubMedCrossRefGoogle Scholar
  8. 8.
    Delmonico M, Harris T, Lee J, Visser M, Nevitt M, Kritchevsky S, Tylavsky F, Newman A (2007) Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women. J Am Geriatr Soc 55:769–774PubMedCrossRefGoogle Scholar
  9. 9.
    Janssen I, Heymsfield S, Ross R (2002) Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and disability. J Am Geriatr Soc 50:889–896PubMedCrossRefGoogle Scholar
  10. 10.
    Janssen I, Baumgartner R, Ross R, Rosenberg I, Roubenof R (2004) Skeletal muscle cutpoints associated with elevated physical disability risk in older men and women. Am J Epidemiol 159:413–421PubMedCrossRefGoogle Scholar
  11. 11.
    Cruz-Jentoft A, Baeyens J, Bauer J, Boirie Y, Cederholm T, Landi F, Martin F, Michel J, Rolland Y, Schneider S, Topinkova E, Vandewoude M, Zamboni M (2010) Sarcopenia: European consensus on definition and diagnosis. Report of the European Working Group on Sarcopenia in Older People. Age Ageing 39:412–423PubMedCrossRefGoogle Scholar
  12. 12.
    Goodpaster B, Park S, Harris T, Kritchevsky S, Nevitt M, Schwartz A, Simonsick E, Tylavsky F, Visser M, Newman A (2006) The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. J Gerontol A Biol Sci Med Sci 61:1059–1064PubMedCrossRefGoogle Scholar
  13. 13.
    World Health Organization (WHO Scientific Group) (2003) Prevention and management of osteoporosis: report of a WHO scientific group. World Health Organ Tech Rep Ser 921:1–192Google Scholar
  14. 14.
    World Health Organization (WHO Study Group) (1993) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: report of a WHO Study Group. World Health Organ Tech Rep Ser 843:1–129Google Scholar
  15. 15.
    Di Monaco M, Vallero F, Di Monaco R, Tappero R (2011) Prevalence of sarcopenia and its association with osteoporosis in 313 older women following a hip fracture. Arch Gerontol Geriatr 52:71–74PubMedCrossRefGoogle Scholar
  16. 16.
    Weigl M, Cieza A, Cantista P, Reinhardt J, Stucki G (2008) Determinants of disability in chronic musculoskeletal conditions: a literature review. Eur J Phys Rehabil Med 44:67–79PubMedGoogle Scholar
  17. 17.
    Frost H (1987) Bone “mass” and the “mechanostat”: a proposal. Anat Rec 219:1–9PubMedCrossRefGoogle Scholar
  18. 18.
    Evans W (1997) Functional and metabolic consequences of sarcopenia. J Nutr 127:998S–1003SPubMedGoogle Scholar
  19. 19.
    Guralnik JM, Ferrucci L, Balfour JL, Volpato S, Di Iorio A (2001) Progressive versus catastrophic loss of the ability to walk: implications for the prevention of mobility loss. J Am Geriatr Soc 49:1463–1470PubMedCrossRefGoogle Scholar
  20. 20.
    Roth SM, Ferrell RF, Hurley BF (2000) Strength training for the prevention and treatment of sarcopenia. J Nutr Health Aging 4:143–155PubMedGoogle Scholar
  21. 21.
    Uusi-Rasi K, Kannus P, Karinkanta S, Pasanen M, Patil R, Lamberg-Allardt C, Sievänen H (2012) Study protocol for prevention of falls: a randomized controlled trial of effects of vitamin D and exercise on falls prevention. BMC Geriatr 12:12. doi:10.1186/1471-2318-12-12 PubMedCrossRefGoogle Scholar
  22. 22.
    Uusi-Rasi K, Rauhio A, Kannus P, Pasanen M, Kukkonen-Harjula K, Fogelholm M, Sievänen H (2010) Three-month weight reduction does not compromise bone strength in obese premenopausal women. Bone 46:1286–1293PubMedCrossRefGoogle Scholar
  23. 23.
    Heymsfield S, Smith R, Aulet M, Bensen B, Lichtman S, Wang J, Pierson R (1990) Appendicular skeletal muscle mass: measurement by dual-photon absorptiometery. Am J Clin Nutr 52:214–218PubMedGoogle Scholar
  24. 24.
    Guralnik J, Simonsick E, Ferrucci L et al (1994) A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49(2):M85–M94PubMedCrossRefGoogle Scholar
  25. 25.
    Podsiadlo D, Richardson S (1991) The timed “up & go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39(2):142–148PubMedGoogle Scholar
  26. 26.
    Lauretani F, Russo C, Bandinelli S, Bartali B, Cavazzini C, Di Iorio A, Corsi A, Rantanen T, Guralnik J, Ferrucci L (2003) Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol 95:1851–1860PubMedGoogle Scholar
  27. 27.
    Stigman S, Rintala P, Kukkonen-Harjula K, Kujala U, Rinne M, Fogelholm M (2009) Eight-year-old children with high cardiorespiratory fitness have lower overall and abdominal fatness. Int J Pediatr Obes 4:98–105PubMedCrossRefGoogle Scholar
  28. 28.
    Kanis J, Johnell O, Oden A, Jonsson B, De Laet C, Dawson A (2000) Risk of hip fracture according to the World Health Organisation criteria for osteopenia and osteoporosis. Bone 27:585–590PubMedCrossRefGoogle Scholar
  29. 29.
    Guggenbuhl P, Dufour R, Liu-Léage SH, Cortet B (2011) Efficiency of bone density testing by dual-biophotonic X-rays absortiometry for diagnosis of osteoporosis according to French guideline recommendations: the PRESAGE study. Joint Bone Spine 78(5):493–498PubMedCrossRefGoogle Scholar
  30. 30.
    Iannuzzi-Sucich M, Prestwood K, Kenny A (2002) Prevalence of sarcopenia and predictors of skeletal muscle mass in healthy, older men and women. J Gerontol A Biol Sci Med Sci 57(12):M772–M777PubMedCrossRefGoogle Scholar
  31. 31.
    Melton L, Khosla S, Crowson C, O’Connor MK, O’Fallon M, Riggs L (2000) Epidemiology of sarcopenia. J Am Geriatr Soc 48:625–630PubMedGoogle Scholar
  32. 32.
    Janssen I (2006) Influence of sarcopenia on the development of physical disability: the Cardiovascular Health Study. J Am Geriatr Soc 54:56–62PubMedCrossRefGoogle Scholar
  33. 33.
    Baumgartner R, Wayne S, Waters D, Janssen I, Gallagher D, Morley J (2004) Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly. Obes Res 12(12):1995–2004PubMedCrossRefGoogle Scholar
  34. 34.
    Shin H, Panton L, Dutton G, Ilich J (2011) Relationship of physical performance with body composition and bone mineral density in individuals over 60 years of age: a systematic review. J Aging Res 2011:191896. doi:10.4061/2011/191896 PubMedGoogle Scholar
  35. 35.
    Guralnik J, Ferrucci L, Pieper C, Leveille S, Markides K, Ostir G, Studenski S, Berkman L, Wallace R (2000) Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci 55(4):M221–M231PubMedCrossRefGoogle Scholar
  36. 36.
    Ostir G, Markides K, Black S, Goodwin J (1998) Lower body functioning as a predictor of subsequent disability among older Mexican Americans. J Gerontol Med Sci 53A:M491–M495CrossRefGoogle Scholar
  37. 37.
    Guralnick J, Ferrucci L, Simonsick E, Salive M, Wallace R (1995) Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 332:556–561CrossRefGoogle Scholar
  38. 38.
    Cesari M, Kritchevsky S, Newman A, Simonsick E, Harris T, Penninx B, Brach J, Tylavsky F, Satterfield S, Bauer D, Rubin S, Visser M, Pahor M (2009) Added value of physical performance measures in predicting adverse health-related events: results from the Health, Aging and Body Composition Study. JAGS 57:251–259CrossRefGoogle Scholar
  39. 39.
    Woods J, Iuliano-Burns S, King S, Strauss B, Walker K (2011) Poor physical function in elderly women in low-level aged care is related to muscle strength rather than to measures of sarcopenia. Clin Interv Aging 6:67–76PubMedGoogle Scholar
  40. 40.
    Waters D, Baumgartner R, Garry P, Vellas B (2010) Advantages of dietary, exercise-related, and therapeutic interventions to prevent and treat sarcopenia in adult patients: an update. Clin Interv Aging 5:259–270PubMedCrossRefGoogle Scholar
  41. 41.
    Roubennoff R, Hughes V (2000) Sarcopenia: current concepts. J Gerontol A Biol Sci Med Sci 55(12):M716–M724CrossRefGoogle Scholar
  42. 42.
    Chumlea W, Cesari M, Evans W, Ferrucci L, Fielding R, Pahor M, Studenski S, Vellas B, The Task Force Members (2011) Sarcopenia: designing phase IIB trials. International Working Group on Sarcopenia. J Nutr Health Aging 15(6):450–455PubMedCrossRefGoogle Scholar
  43. 43.
    Cooper C, Dere W, Evans W, Kanis J, Rizzoli R, Sayer A, Sieber C, Kaufman J, Abellan van Kan G, Boonen S, Adachi J, Mitlak B, Tsouderos Y, Rolland Y, Reginster J (2012) Frailty and sarcopenia: definitions and outcome parameters. Osteoporos Int. doi:10.1007/s00198-012-1913-1

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2012

Authors and Affiliations

  • R. Patil
    • 1
  • K. Uusi-Rasi
    • 1
    • 2
  • M. Pasanen
    • 1
  • P. Kannus
    • 1
    • 3
    • 4
  • S. Karinkanta
    • 1
  • H. Sievänen
    • 1
  1. 1.The UKK Institute for Health Promotion ResearchTampereFinland
  2. 2.Research DepartmentTampere University HospitalTampereFinland
  3. 3.Medical SchoolUniversity of TampereTampereFinland
  4. 4.Division of Orthopaedics and Traumatology, Department of Trauma, Musculoskeletal Surgery and RehabilitationTampere University HospitalTampereFinland

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