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Operational definitions of sarcopenia and their associations with 5-year changes in falls risk in community-dwelling middle-aged and older adults



Sarcopenia may be diagnosed in the clinic using operational definitions based on low muscle mass or function. This prospective, population-based study revealed that sex-specific associations may exist between operational definitions of sarcopenia and falls in community-dwelling middle-aged and older adults.


The objective of this study is to verify associations between sarcopenia and falls risk and to determine changes in sarcopenia prevalence over 5 years in middle-aged and older men and women according to different anthropometric and performance-based operational definitions.


N = 681 volunteers (48 % female; mean ± SD age 61.4 ± 7.0 years) participated in baseline and follow-up assessments (mean 5.1 ± 0.5 years later). Appendicular lean mass (ALM) was assessed by dual-energy X-ray absorptiometry, hand grip (HGS) and lower-limb (LLS) strength were assessed by dynamometry, and falls risk was determined using the physiological profile assessment. Anthropometric definitions (ALM/height squared [ALM–H], ALM/weight × 100 and a residuals method [ALM–R]) and performance-based definitions (HGS, LLS and upper- and lower-limb muscle quality [LMQ]) of sarcopenia were examined. The lowest 20 % of the sex-specific distribution for each definition at baseline was classified as sarcopenia.


Sarcopenia prevalence increased after 5 years for all operational definitions except ALM–H (men: −4.0 %; women: −5.5 %). Men classified with sarcopenia according to anthropometric definitions, and women classified with sarcopenia according to performance-based definitions, had significant increases in falls risk over 5 years (all P < 0.05) compared to individuals without sarcopenia. Significant sex interactions were observed for ALM-R, LLS and LMQ (all P < 0.05) definitions.


Sarcopenia prevalence generally increases at a higher rate when assessed using performance-based definitions. Sarcopenia is associated with increases in falls risk over 5 years in community-dwelling middle-aged and older adults, but sex-specific differences may exist according to different anthropometric or performance-based definitions.

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This work was supported by the National Health and Medical Research Council of Australia, Arthritis Foundation of Australia, Tasmanian Community Fund and University of Tasmania Institutional Research Grants Scheme. We gratefully acknowledge the efforts of the TASOAC participants, staff and volunteers, particularly the study coordinator Catrina Boon.

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Scott, D., Hayes, A., Sanders, K.M. et al. Operational definitions of sarcopenia and their associations with 5-year changes in falls risk in community-dwelling middle-aged and older adults. Osteoporos Int 25, 187–193 (2014).

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  • Falls
  • Muscle mass
  • Muscle strength
  • Sarcopenia