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Definitions of Sarcopenia: Associations with Previous Falls and Fracture in a Population Sample

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Abstract

Sarcopenia is common in later life and may be associated with adverse health outcomes such as disability, falls and fracture. There is no consensus definition for its diagnosis although diagnostic algorithms have been proposed by the European Working Group for Sarcopenia in Older People (EWGSOP), the International Working Group on Sarcopenia (IWGS) and the Foundation for the National Institutes of Health Sarcopenia Project (FNIH). More recently, Binkley and colleagues devised a score-based system for the diagnosis of “dysmobility syndrome” in an attempt to combine adverse musculoskeletal phenotypes, including sarcopenia and osteoporosis, in order to identify older individuals at particular risk. We applied these criteria to participants from the Hertfordshire Cohort Study to define their prevalence in an unselected cohort of UK community-dwelling older adults and assess their relationships with previous falls and fracture. Body composition and areal bone mineral density were measured using dual-energy X-ray absorptiometry, gait speed was determined by a 3-m walk test and grip strength was assessed with a Jamar hand-held dynamometer. Researcher-administered questionnaires were completed detailing falls and fracture history. The prevalence of sarcopenia in this cohort was 3.3, 8.3 and 2.0 % using the EWGSOP, IWGS and related definition of FNIH, respectively; 24.8 % of individuals had dysmobility syndrome. Individuals with dysmobility reported significantly higher number of falls (last year and since the age of 45 years) (p < 0.01) than those without it, but no increased fracture rate was observed in this group (p = 0.96). Those with sarcopenia as defined by the IWGS reported significantly higher falls in the last year and prevalent fractures (falls in the last year: OR 2.51; CI 1.09–5.81; p = 0.03; fractures OR 2.50; CI 1.05–5.92; p = 0.04) but these significant associations were not seen when the EWGSOP definition was applied. The IWGS definition of sarcopenia appears to be an effective means of identifying individuals at risk of prevalent adverse musculoskeletal events.

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Acknowledgments

The Hertfordshire Cohort Study was supported by the Medical Research Council of Great Britain; Arthritis Research UK and the International Osteoporosis Foundation. The work herein was also supported by the NIHR Nutrition BRC, University of Southampton and the NIHR Musculoskeletal BRU, University of Oxford. We thank all of the men and women who took part in the Hertfordshire Cohort Study; the HCS Research Staff and Vanessa Cox who managed the data. Michael Clynes was supported by the University of Southampton National Institute of Health.

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Authors and Affiliations

  1. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK

    M. A. Clynes, M. H. Edwards, E. M. Dennison & C. Cooper

  2. University of Wisconsin Osteoporosis Research Program, Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 2870 University Ave, Suite 100, Madison, WI, 53705, USA

    B. Buehring & N. Binkley

  3. GRECC, William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI, 53705, USA

    B. Buehring & N. Binkley

  4. Victoria University, Wellington, New Zealand

    E. M. Dennison

  5. NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, OX3 5UG, UK

    C. Cooper

  6. NIHR Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Trust, Southampton General Hospital, Southampton, SO16 6YD, UK

    C. Cooper

Authors
  1. M. A. Clynes
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  2. M. H. Edwards
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  3. B. Buehring
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  4. E. M. Dennison
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  5. N. Binkley
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  6. C. Cooper
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Correspondence to C. Cooper.

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Conflict of interest

Cyrus Cooper has received consultancy fees and honoraria from Servier; Eli Lilly; Merck; Amgen; Alliance; Novartis; Medtronic; GSK and Roche. Bjoern Buehring has received grants from Lilly, Extendicare Foundation and GE Healthcare. Elaine Dennsion has received speaking fees from Lilly. Michael Clynes, Mark Edwards and Neil Binkley have no interests to declare.

Human and Animal Rights and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Clynes, M.A., Edwards, M.H., Buehring, B. et al. Definitions of Sarcopenia: Associations with Previous Falls and Fracture in a Population Sample. Calcif Tissue Int 97, 445–452 (2015). https://doi.org/10.1007/s00223-015-0044-z

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  • DOI: https://doi.org/10.1007/s00223-015-0044-z

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