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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

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Abstract

Summary

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.

Introduction

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.

Methods

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.

Results

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.

Conclusions

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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References

  1. Cooper C, Dere W, Evans W, Kanis J, Rizzoli R, Sayer A, Sieber C, Kaufman JM, Abellan van Kan G, Boonen S (2012) Frailty and sarcopenia: definitions and outcome parameters. Osteoporos Int:1–10

  2. Hughes VA, Frontera WR, Wood M, Evans WJ, Dallal GE, Roubenoff R, Fiatarone Singh MA (2001) Longitudinal muscle strength changes in older adults: influence of muscle mass, physical activity and health. J Gerontol A Biol Sci Med Sci 56(5):209–217

    Article  Google Scholar 

  3. Goodpaster BH, Park SW, Harris TB, Kritchevsky SB, Nevitt M, Schwartz AV, Simonsick EM, Tylavsky FA, Visser M, Newman AB (2006) The loss of skeletal muscle strength, mass, and quality in older adults: the health, ageing and body composition study. J Gerontol A Biol Sci Med Sci 61(10):1059–1064

    Article  PubMed  Google Scholar 

  4. Russ D, Gregg-Cornell K, Conaway M, Clark B (2012) Evolving concepts on the age-related changes in “muscle quality”. J Cachex Sarcopenia Muscle 3(2):95–109. doi:10.1007/s13539-011-0054-2

    Article  Google Scholar 

  5. Clark BC, Manini TM (2008) Sarcopenia ≠ dynapenia. J Gerontol A Biol Sci Med Sci 63(8):829–834

    Article  PubMed  Google Scholar 

  6. Abellan van Kan G, Houles M, Vellas B (2012) Identifying sarcopenia. Curr Opin Clin Nutr Metab Care 15:000–000

    Article  Google Scholar 

  7. Baumgartner RN, Romero L, Garry PJ, Heymsfield SB, Koehler KM, Gallagher D, Ross RR, Lindeman RD (1998) Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 147(8):755–763

    Article  CAS  PubMed  Google Scholar 

  8. Janssen I, Heymsfield SB, Ross R (2002) Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 50(5):889–896

    Article  PubMed  Google Scholar 

  9. Newman AB, Kupelian V, Visser M, Simonsick E, Goodpaster B, Nevitt M, Kritchevsky SB, Tylavsky FA, Rubin SM, Harris TB (2003) Sarcopenia: alternative definitions and associations with lower extremity function. J Am Geriatr Soc 51(11):1602–1609

    Article  PubMed  Google Scholar 

  10. Abellan Van Kan G (2009) Epidemiology and consequences of sarcopenia. J Nutr Health Aging 13(8):708–712

    Article  CAS  PubMed  Google Scholar 

  11. Woods JL, Iuliano-Burns S, King SJ, Strauss BJ, Walker KZ (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 6:67–76

    PubMed  PubMed Central  Google Scholar 

  12. Foley S, Quinn S, Jones G (2010) Pedometer determined ambulatory activity and bone mass: a population-based longitudinal study in older adults. Osteoporos Int 21(11):1809–1816

    Article  CAS  PubMed  Google Scholar 

  13. Sakai Y, Ito H, Meno T, Numata M, Jingu S (2006) Comparison of body composition measurements obtained by two fan-beam DXA instruments. J Clin Densitom 9(2):191–197

    Article  PubMed  Google Scholar 

  14. Scott D, Blizzard L, Fell J, Jones G (2010) Prospective associations between ambulatory activity, body composition and muscle function in older adults. Scand J Med Sci Sports 21(6):e168–e175. doi:10.1111/j.1600-0838.2010.01229.x

    Article  PubMed  Google Scholar 

  15. Metter EJ, Lynch N, Conwit R, Lindle R, Tobin J, Hurley B (1999) Muscle quality and age: cross-sectional and longitudinal comparisons. J Gerontol A Biol Sci Med Sci 54(5):207–218

    Article  Google Scholar 

  16. Lord SR, Menz HB, Tiedemann A (2003) A physiological profile approach to falls risk assessment and prevention. Phys Ther 83(3):237–252

    PubMed  Google Scholar 

  17. Delmonico MJ, Harris TB, Lee JS, Visser M, Nevitt M, Kritchevsky SB, Tylavsky FA, Newman AB (2007) Alternative definitions of sarcopenia, lower extremity performance and functional impairment with ageing in older men and women. J Am Geriatr Soc 55(5):769–774

    Article  PubMed  Google Scholar 

  18. Hairi NN, Cumming RG, Naganathan V, Handelsman DJ, Le Couteur DG, Creasey H, Waite LM, Seibel MJ, Sambrook PN (2010) Loss of muscle strength, mass (sarcopenia) and quality (specific force) and its relationship with functional limitation and physical disability: the Concord Health and Ageing in Men Project. J Am Geriatr Soc 58(11):2055–2062

    Article  PubMed  Google Scholar 

  19. Lord SR, Sambrook PN, Gilbert C, Kelly PJ, Nguyen T, Webster IW, Eisman JA (1994) Postural stability, falls and fractures in the elderly: results from the Dubbo osteoporosis epidemiology study. Med J Aust 160(11):684–685, 688–691

    CAS  PubMed  Google Scholar 

  20. Menz HB, Morris ME, Lord SR (2006) Foot and ankle risk factors for falls in older people: a prospective study. J Gerontol Ser A Biol Sci Med Sci 61(8):866–870

    Article  Google Scholar 

  21. Delbaere K, Close JC, Brodaty H, Sachdev P, Lord SR (2010) Determinants of disparities between perceived and physiological risk of falling among elderly people: cohort study. BMJ 341

  22. Moreland JD, Richardson JA, Goldsmith CH, Clase CM (2004) Muscle weakness and falls in older adults: a systematic review and meta–analysis. J Am Geriatr Soc 52(7):1121–1129

    Article  PubMed  Google Scholar 

  23. Newman AB, Kupelian V, Visser M, Simonsick EM, Goodpaster BH, Kritchevsky SB, Tylavsky FA, Rubin SM, Harris TB (2006) Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J Gerontol A Biol Sci Med Sci 61(1):72–77

    Article  PubMed  Google Scholar 

  24. Gale CR, Martyn CN, Cooper C, Sayer AA (2007) Grip strength, body composition and mortality. Int J Epidemiol 36(1):228–235. doi:10.1093/ije/dyl224

    Article  PubMed  Google Scholar 

  25. Wijnhoven HAH, Snijder MB, Van Bokhorst-de Van Der Schueren M, Deeg D, Visser M (2012) Region-specific fat mass and muscle mass and mortality in community-dwelling older men and women. Gerontology 58(1):32–40

    Article  PubMed  Google Scholar 

  26. Manini TM, Clark BC (2012) Dynapenia and aging: an update. J Gerontol Ser A Biol Sci Med Sci 67A(1):28–40. doi:10.1093/gerona/glr010

    Article  Google Scholar 

  27. Sorkin JD, Muller DC, Andres R (1999) Longitudinal change in height of men and women: implications for interpretation of the body mass index: the Baltimore longitudinal study of aging. Am J Epidemiol 150(9):969–977

    Article  CAS  PubMed  Google Scholar 

  28. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel J-P, Rolland Y, Schneider SM, 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(4):412–423

    Article  PubMed  Google Scholar 

  29. Patil R, Uusi-Rasi K, Pasanen M, Kannus P, Karinkanta S, Sievänen H (2012) Sarcopenia and osteopenia among 70–80-year-old home-dwelling Finnish women: prevalence and association with functional performance. Osteoporos Int:1–10

  30. Morley JE (2012) Sarcopenia in the elderly. Fam Pract 29(suppl 1):i44–i48

    Article  PubMed  Google Scholar 

  31. Patel HP, Syddall HE, Jameson K, Robinson S, Denison H, Roberts HC, Edwards M, Dennison E, Cooper C, Aihie Sayer A (2013) Prevalence of sarcopenia in community-dwelling older people in the UK using the European working group on sarcopenia in older people (EWGSOP) definition: findings from the Hertfordshire cohort study (HCS). Age Ageing. doi:10.1093/ageing/afs197

    Google Scholar 

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Acknowledgements

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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Correspondence to D. Scott.

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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). https://doi.org/10.1007/s00198-013-2431-5

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  • DOI: https://doi.org/10.1007/s00198-013-2431-5

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