Osteoporosis International

, Volume 30, Issue 1, pp 167–176 | Cite as

Utility of four sarcopenia criteria for the prediction of falls-related hospitalization in older Australian women

  • M. SimEmail author
  • R. L. Prince
  • D. Scott
  • R. M. Daly
  • G. Duque
  • C. A. Inderjeeth
  • K. Zhu
  • R. J. Woodman
  • J. M. Hodgson
  • J. R. Lewis
Original Article



Numerous sarcopenia definitions are not associated with increased falls-related hospitalization risk over 5 years to 9.5 years in older community-dwelling Australian women. Measures of muscle strength and physical function, but not appendicular lean mass (measured by dual-energy X-ray absorptiometry) may help discriminate the risk of falls-related hospitalization.


The aim of this prospective, population-based cohort study of 903 Caucasian-Australian women (mean age 79.9 ± 2.6 years) was to compare the clinical utility of four sarcopenia definitions for the prediction of falls-related hospitalization over 9.5 years.


The four definitions were the United States Foundation for the National Institutes of Health (FNIH), the European Working Group on Sarcopenia in Older People (EWGSOP), and modified FNIH (AUS-POPF) and EWGSOP (AUS-POPE) definitions using Australian population-specific cut points (< 2 SD below the mean of young healthy Australian women). Components of sarcopenia including muscle strength, physical function, and appendicular lean mass (ALM) were quantified using hand grip strength, timed-up-and-go (TUG), and dual-energy X-ray absorptiometry (DXA), respectively. Incident 9.5-year falls-related hospitalization were captured by linked data.


Baseline prevalence of sarcopenia according to FNIH (9.4%), EWGSOP (24.1%), AUS-POPF (12.0%), and AUS-POPE (10.7%) differed substantially. Sarcopenia did not increase the relative hazard ratio (HR) for falls-related hospitalization before or after adjustment for age (aHR): FNIH aHR 1.00 95%CI (0.69–1.47), EWGSOP aHR 1.20 95%CI (0.93–1.54), AUS-POPF aHR 0.96 95%CI (0.68–1.35), and AUS-POPE aHR 1.33 95%CI (0.94–1.88). When examining individual components of sarcopenia, only muscle strength and physical function but not ALM (adjusted for height2 or BMI) were associated with falls-related hospitalization.


Current definitions of sarcopenia were not associated with falls-related hospitalization risk in this cohort of community-dwelling older Australian women. Finally, measures of muscle strength and physical function, but not ALM (measured by DXA) may help discriminate the risk of falls-related hospitalization.


Falls-related hospitalization Geriatrics Muscle mass Muscle strength Physical function 



The authors wish to thank the staff at the Western Australia Data Linkage Branch, Hospital Morbidity Data Collection and Registry of Births, Deaths, and Marriages for their work on providing the data for this study.

Author contributions

M. S., R. L. P., D. S., R. M. D., G. D., C. A. I, K. Z., R. J. W., J. M. H., and J. R. L. conceived and designed the study. J. R. L, K. Z., and R. L. P. collected the data. M. S., J. M. H, J. R. L., and R. L. P. prepared the manuscript; all authors reviewed the manuscript; M. S. had the primary responsibility for the final content. All authors read and approved the final manuscript.


The Perth Longitudinal Study of Aging in Women (PLSAW) was funded by Healthway, the Western Australian Health Promotion Foundation, and by project grants 254627, 303169, and 572604 from the National Health and Medical Research Council (NHMRC) of Australia. The salary of J. M. H. is supported by a NHMRC of the Australia Senior Research Fellowship and a Royal Perth Hospital Medical Research Foundation Fellowship. The salaries of J. R. L. and D. S. are supported by a NHMRC of Australia Career Development Fellowship. None of these funding agencies had any input into any aspect of the design and management of this study.

Compliance with ethical standards

Conflict of interest


Ethics statement

All participants provided written informed consent. Ethics approval was granted by the Human Ethics Committee of the University of Western Australia. Both studies were retrospectively registered on the Australian New Zealand Clinical Trials Registry (CAIFOS trial registration number ACTRN12615000750583 and PLSAW trial registration number ACTRN12617000640303) and complied with the Declaration of Helsinki. Human ethics approval for the use of linked data was provided by the Human Research Ethics Committee of the Western Australian Department of Health (project number 2009/24).

Supplementary material

198_2018_4755_MOESM1_ESM.docx (297 kb)
ESM 1 (DOCX 296 KB)


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  1. 1.School of Medical and Health SciencesEdith Cowan UniversityJoondalupAustralia
  2. 2.Medical SchoolThe University Western AustraliaPerthAustralia
  3. 3.Department of Endocrinology and DiabetesSir Charles Gairdner HospitalNedlandsAustralia
  4. 4.Department of Medicine, School of Clinical Sciences at Monash HealthMonash UniversityClaytonAustralia
  5. 5.Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School – Western CampusThe University of MelbourneSt AlbansAustralia
  6. 6.Institute for Physical Activity and Nutrition, School of Exercise and Nutrition SciencesDeakin UniversityGeelongAustralia
  7. 7.Department of Medicine-Western HealthThe University of MelbourneSt AlbansAustralia
  8. 8.North Metropolitan Health ServiceNedlandsAustralia
  9. 9.Flinders Centre for Epidemiology and BiostatisticsFlinders UniversityAdelaideAustralia
  10. 10.Centre for Kidney Research, Children’s Hospital at Westmead, School of Public Health, Sydney Medical SchoolThe University of SydneySydneyAustralia

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