Adipose tissue compartments, muscle mass, muscle fat infiltration, and coronary calcium in institutionalized frail nonagenarians



to compare the different adipose tissue (AT) compartments, muscle mass, muscle fat infiltration, coronary calcium, as well as associations among changes in different AT compartments between frail and robust nonagenarians.

Materials and Methods

Forty-two elderly subjects took part in this study: 29 institutionalized frail elderly (92.0 ± 8 years) and 13 robust elderly (88.2 ± 4.1 years). All patients underwent helical thoracic, abdominal and thigh computed tomography (CT). In addition, a non-enhanced prospectively ECG-triggered cardiac CT was performed to quantify the amount of coronary artery calcification and measure pericardial AT.


The robust group presented significantly greater pericardial and abdominal AT volume, as well as greater axial and appendicular muscle size and high-density muscle tissue (greater muscle quality) than the frail group (P < 0.001), whereas no differences between groups were observed in coronary calcium. There were positive correlations between pericardial AT with visceral and subcutaneous AT values, as well as between pericardial AT and quadriceps, hamstrings, psoas and paravertebral low-density muscle tissues in the frail and robust groups (r = 0.57 to 0.91,P < 0.05).


Robust group presented greater muscle size and quality in the axial and appendicular muscles, as well as pericardial and abdominal AT area than the frail group.

Key Points

Robust nonagenarians presented more pericardial and abdominal AT volume than frail.

Frailty is associated with lower muscle size and high-density muscle tissue.

Muscle-fat infiltration shares analogous pattern of visceral and pericardial AT distribution.

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The scientific guarantor of this publication is Mikel Izquierdo, Head of Department of Health Sciences, Public University of Navarra. This study has received funding by the Spanish Department of Health and Institute Carlos III of the Government of Spain [Spanish Net on Aging and frailty; (RETICEF)], and Economy and Competitivity Department of the Government of Spain, under grants numbered RD12/043/0002, and DEP2011-24105, respectively. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective, cross-sectional study, observational multicenter study, performed at one institution.

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Correspondence to Mikel Izquierdo.

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Idoate, F., Cadore, E.L., Casas-Herrero, A. et al. Adipose tissue compartments, muscle mass, muscle fat infiltration, and coronary calcium in institutionalized frail nonagenarians. Eur Radiol 25, 2163–2175 (2015).

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  • Adipose tissue
  • Frailty
  • Muscle quality
  • Coronary calcium
  • Muscle fat infiltration