Osteoporosis International

, Volume 28, Issue 7, pp 2069–2079 | Cite as

Sarcopenia is associated with disability status—results from the KORA-Age study

  • A. PhillipsEmail author
  • R. Strobl
  • S. Vogt
  • K.-H. Ladwig
  • B. Thorand
  • E. Grill
Original Article



We estimated the prevalence of sarcopenia and its impact on disability in older people. Sarcopenia was found to contribute to higher disability scores. However, our study was not able to show any influence of sarcopenia on the rate of functional decline. This directs attention to an accurate diagnosis of sarcopenia as the onset may be influenced, but its rate may not.


The objectives of this study using data from a population-based cohort were to estimate the prevalence of sarcopenia in older people in Germany and to test the hypothesis that sarcopenia is associated with disability in older adults.


Cross-sectional (n = 927) and longitudinal analyses (n = 859) of participants aged ≥65 years at baseline from southern Germany enrolled in the Cooperative Health Research in the Region Augsburg (KORA)-Age study (2009–2012). Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People (EWGSOP) algorithm which includes the presence of both low muscle mass and low muscle function (strength or performance). Disability status was measured by the Health Assessment Questionnaire–Disability Index (HAQ-DI). The presence of disability was defined as HAQ-DI >0. Directed acyclic graphs (DAGs) were constructed to identify potential confounders. The effect of sarcopenia on disability was analyzed using linear mixed effect models with disability values as a continuous outcome.


The overall prevalence of sarcopenia was 5.7% (men 4.0%, women 7.5%) and increased with age. The 3-year incidence of disability was 32.7%. After adjustment for potential confounders, presence of sarcopenia was significantly associated with higher disability scores (0.142 [confidence interval 0.029–0.254]).


The prevalence of sarcopenia is consistent with estimates from other European studies using this algorithm. Our results suggest that sarcopenia can contribute to higher disability scores in older adults. However, our study was not able to show any influence of sarcopenia on the rate of functional decline using the EWGSOP diagnostic algorithm for sarcopenia. This directs attention to an accurate diagnosis of sarcopenia as the onset may be influenced, but its rate may not.


Disability EWGSOP Muscle mass Older people Sarcopenia 



We thank the team at the KORA Study Centre in Augsburg who carried out the fieldwork for this study and the team at the Helmholtz Zentrum München for maintaining this complex data.

Compliance with ethical standards

Approval from the ethics committee of the Bavarian Medical Association was obtained (reference number 08064).


This study was funded by the German Research Foundation (Deutsche Forschungsgemeinschaft) (GR 3608/1-1). The KORA-Age project was financed by the German Federal Ministry of Education and Research (BMBF FKZ 01ET0713 and FKZ 01ET1003A, C) as part of the “Health in old age” program. SV was supported by the Kompetenznetz Adipositas (Competence Network Obesity), funded by the German Federal Ministry of Education and Research (FKZ 01GI1121B).The financial sponsors played no role in the design, execution, analysis, and interpretation of data or writing of the study.

Conflicts of interest


Supplementary material

198_2017_4027_MOESM1_ESM.pdf (174 kb)
Figure 1 (PDF 173 kb)
198_2017_4027_MOESM2_ESM.pdf (421 kb)
Figure 2 (PDF 420 kb)
198_2017_4027_MOESM3_ESM.pdf (156 kb)
Table 1 (PDF 155 kb)
198_2017_4027_MOESM4_ESM.pdf (232 kb)
Table 2 (PDF 231 kb)


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2017

Authors and Affiliations

  1. 1.Institute for Medical Informatics, Biometry and EpidemiologyLudwig-Maximilians-Universität MünchenMunichGermany
  2. 2.German Center for Vertigo and Balance DisordersLudwig-Maximilians-Universität MünchenMunichGermany
  3. 3.Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH)MunichGermany
  4. 4.Department for Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der IsarTechnical University of MunichMunichGermany

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