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Diagnostic criteria for sarcopenia and physical performance

AGE volume 36, pages 275–285 (2014)Cite this article

Abstract

Relative and absolute muscle mass and muscle strength are used as diagnostic criteria for sarcopenia. We aimed to assess which diagnostic criteria are most associated with physical performance in 180 young (18–30 years) and 281 healthy old participants (69–81 years) of the European study MYOAGE. Diagnostic criteria included relative muscle mass (total or appendicular lean mass (ALM) as percentage of body mass), absolute muscle mass (ALM/height squared and total lean mass), knee extension torque, and handgrip strength. Physical performance comprised walking speed, Timed Up and Go test (TUG), and in a subgroup physical fitness. Diagnostic criteria for sarcopenia and physical performance were standardized, and the associations were analyzed using linear regression models stratified by age category, with adjustments for age, gender, and country. In old participants, relative muscle mass was associated with faster walking speed, faster TUG, and higher physical fitness (all p < 0.001). Absolute muscle mass was not associated with physical performance. Knee extension torque and handgrip strength were associated with faster walking speed (both p ≤ 0.003). Knee extension torque was associated with TUG (p = 0.001). Knee extension torque and handgrip strength were not associated with physical fitness. In young participants, there were no significant associations between diagnostic criteria for sarcopenia and physical performance, except for a positive association between relative muscle mass and physical fitness (p < 0.001). Relative muscle mass, defined as lean mass or ALM percentage, was most associated with physical performance. Absolute muscle mass including ALM/height squared was not associated with physical performance. This should be accounted for when defining sarcopenia.

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References

  • Astrand PO, Rodahl K (1986) Textbook of work physiology, 3rd edn. McGraw-Hill, New York, pp 363–384

    Google Scholar 

  • Auyeung TW, Lee JS, Leung J, Kwok T, Woo J (2012) Adiposity to muscle ratio predicts incident physical limitation in a cohort of 3,153 older adults—an alternative measurement of sarcopenia and sarcopenic obesity. Age (Dordr). doi:10.1007/s11357-012-9423-9

    Google Scholar 

  • Barbat-Artigas S, Rolland Y, Cesari M, van Abellan KG, Vellas B, Aubertin-Leheudre M (2012) Clinical relevance of different muscle strength indexes and functional impairment in women aged 75 years and older. J Gerontol A Biol Sci Med Sci 68(7):811–819

    PubMed  Article  Google Scholar 

  • Baumgartner RN, Stauber PM, McHugh D, Koehler KM, Garry PJ (1995) Cross-sectional age differences in body composition in persons 60+ years of age. J Gerontol A Biol Sci Med Sci 50:M307–M316

    CAS  PubMed  Article  Google Scholar 

  • Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR et al (1998) Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 147:755–763

    CAS  PubMed  Article  Google Scholar 

  • Bijlsma AY, Meskers CG, Ling CH, Narici M, Kurrle SE, Cameron ID et al (2012) Defining sarcopenia: the impact of different diagnostic criteria on the prevalence of sarcopenia in a large middle aged cohort. Age (Dordr) 35(3):871–881

    Article  Google Scholar 

  • Bunout D, de la Maza MP, Barrera G, Leiva L, Hirsch S (2011) Association between sarcopenia and mortality in healthy older people. Australas J Ageing 30:89–92

    PubMed  Article  Google Scholar 

  • Burns JM, Johnson DK, Watts A, Swerdlow RH, Brooks WM (2010) Reduced lean mass in early Alzheimer disease and its association with brain atrophy. Arch Neurol 67:428–433

    PubMed Central  PubMed  Article  Google Scholar 

  • Cink RE, Thomas TR (1981) Validity of the Astrand-Ryhming nomogram for predicting maximal oxygen intake. Br J Sports Med 15:182–185

    CAS  PubMed  Article  Google Scholar 

  • Clark BC, Manini TM (2008) Sarcopenia =/= dynapenia. J Gerontol A Biol Sci Med Sci 63:829–834

    PubMed  Article  Google Scholar 

  • Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F et al (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on sarcopenia in older people. Age Ageing 39:412–423

    PubMed  Article  Google Scholar 

  • Delmonico MJ, Harris TB, Lee JS, Visser M, Nevitt M, Kritchevsky SB et al (2007) Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women. J Am Geriatr Soc 55:769–774

    PubMed  Article  Google Scholar 

  • Estrada M, Kleppinger A, Judge JO, Walsh SJ, Kuchel GA (2007) Functional impact of relative versus absolute sarcopenia in healthy older women. J Am Geriatr Soc 55:1712–1719

    PubMed  Article  Google Scholar 

  • Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB et al (2011) Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International Working Group on Sarcopenia. J Am Med Dir Assoc 12:249–256

    PubMed  Article  Google Scholar 

  • Hairi NN, Cumming RG, Naganathan V, Handelsman DJ, Le Couteur DG, Creasey H et al (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 58:2055–2062

    PubMed  Article  Google Scholar 

  • Hyatt RH, Whitelaw MN, Bhat A, Scott S, Maxwell JD (1990) Association of muscle strength with functional status of elderly people. Age Ageing 19:330–336

    CAS  PubMed  Article  Google Scholar 

  • 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 50:889–896

    PubMed  Article  Google Scholar 

  • Karttunen N, Lihavainen K, Sipila S, Rantanen T, Sulkava R, Hartikainen S (2011) Musculoskeletal pain and use of analgesics in relation to mobility limitation among community-dwelling persons aged 75 years and older. Eur J Pain 16(1):140–149

    Article  Google Scholar 

  • Lauretani F, Russo CR, Bandinelli S, Bartali B, Cavazzini C, Di IA et al (2003) Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol 95:1851–1860

    PubMed  Google Scholar 

  • Lebrun CE, van der Schouw YT, de Jong FH, Grobbee DE, Lamberts SW (2006) Fat mass rather than muscle strength is the major determinant of physical function and disability in postmenopausal women younger than 75 years of age. Menopause 13:474–481

    PubMed  Article  Google Scholar 

  • McCully KK, Posner JD (1995) The application of blood flow measurements to the study of aging muscle. J Gerontol A Biol Sci Med Sci 50:130–136

    PubMed  Google Scholar 

  • Newman AB, Kupelian V, Visser M, Simonsick E, Goodpaster B, Nevitt M et al (2003) Sarcopenia: alternative definitions and associations with lower extremity function. J Am Geriatr Soc 51:1602–1609

    PubMed  Article  Google Scholar 

  • Patil R, Uusi-Rasi K, Pasanen M, Kannus P, Karinkanta S, Sievanen H (2012) Sarcopenia and osteopenia among 70-80-year-old home-dwelling Finnish women: prevalence and association with functional performance. Osteoporos Int 24(3):787–796

    PubMed  Article  Google Scholar 

  • Rolland Y, Czerwinski S, Van Abellan KG, Morley JE, Cesari M, Onder G et al (2008) Sarcopenia: its assessment, etiology, pathogenesis, consequences and future perspectives. J Nutr Health Aging 12:433–450

    CAS  PubMed  Article  Google Scholar 

  • Rolland Y, Lauwers-Cances V, Cristini C, van Abellan KG, Janssen I, Morley JE et al (2009) Difficulties with physical function associated with obesity, sarcopenia, and sarcopenic-obesity in community-dwelling elderly women: the EPIDOS (EPIDemiologie de l'OSteoporose) Study. Am J Clin Nutr 89:1895–1900

    CAS  PubMed  Article  Google Scholar 

  • Siconolfi SF, Cullinane EM, Carleton RA, Thompson PD (1982) Assessing VO2max in epidemiologic studies: modification of the Astrand-Rhyming test. Med Sci Sports Exerc 14:335–338

    CAS  PubMed  Google Scholar 

  • Stenholm S, Harris TB, Rantanen T, Visser M, Kritchevsky SB, Ferrucci L (2008) Sarcopenic obesity: definition, cause and consequences. Curr Opin Clin Nutr Metab Care 11:693–700

    PubMed Central  PubMed  Article  Google Scholar 

  • Visser M, Kritchevsky SB, Goodpaster BH, Newman AB, Nevitt M, Stamm E et al (2002) Leg muscle mass and composition in relation to lower extremity performance in men and women aged 70 to 79: the health, aging and body composition study. J Am Geriatr Soc 50:897–904

    PubMed  Article  Google Scholar 

  • Visser M, Goodpaster BH, Kritchevsky SB, Newman AB, Nevitt M, Rubin SM et al (2005) Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. J Gerontol A Biol Sci Med Sci 60:324–333

    PubMed  Article  Google Scholar 

  • Woo J, Leung J, Sham A, Kwok T (2009) Defining sarcopenia in terms of risk of physical limitations: a 5-year follow-up study of 3,153 Chinese men and women. J Am Geriatr Soc 57:2224–2231

    PubMed  Article  Google Scholar 

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Acknowledgments

The authors thank Prof. Dr. E. Seppet for contributing to the study design; M. van der Bij, T.M. Maden-Wilkinson, and Dr. I. Kull for their support; and E. Klaus, Dr. J. Ereline, Dr. T. Kums, H. Aibast, and C. Levergeois for their skillful technical assistance. This study was supported by an unrestricted grant from the seventh framework program MYOAGE (HEALTH-2007-2.4.5-10), 050-060-810 Netherlands Consortium for Healthy Aging, Estonian Science Foundation (grant nos. 8736 and 7823), the Estonian Ministry of Education and Research (project SF01080114As08), and the Association Francais Contres les Myopathies, INSERM, Université Pierre et Marie Curie, the CNRS.

Conflict of interest

None

Ethical approval

The local medical ethical committees of the respective institutions approved the study. Written informed consent was obtained from all participants.

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Affiliations

  1. Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam, The Netherlands

    A. Y. Bijlsma & A. B. Maier

  2. Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands

    A. Y. Bijlsma, N. van den Eshof & R. G. Westendorp

  3. Department of Rehabilitation Medicine, Leiden University Medical Centre, Leiden, The Netherlands

    C. G. M. Meskers

  4. Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland

    S. Sipilä, L. Stenroth & E. Sillanpää

  5. Department of Biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland

    L. Stenroth

  6. School of Healthcare Science, Manchester Metropolitan University, Manchester, UK

    J. S. McPhee, D. A. Jones & M. V. Narici

  7. School of Graduate Entry to Medicine and Health, Division of Clinical Physiology, University of Nottingham, Derby, UK

    M. V. Narici

  8. Institute of Exercise Biology and Physiotherapy, University of Tartu, Tartu, Estonia

    H. Gapeyeva & M. Pääsuke

  9. UPMC UM 76, INSERM U 974, CNRS UMR 7215, Institute of Myology, GH Pitié-Salpêtrière, Paris, France

    T. Voit, Y. Barnouin, J. Y. Hogrel & G. Butler-Browne

Authors
  1. A. Y. Bijlsma
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  2. C. G. M. Meskers
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  3. N. van den Eshof
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  4. R. G. Westendorp
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  5. S. Sipilä
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  6. L. Stenroth
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  7. E. Sillanpää
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  8. J. S. McPhee
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  9. D. A. Jones
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  10. M. V. Narici
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  11. H. Gapeyeva
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  12. M. Pääsuke
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  13. T. Voit
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  14. Y. Barnouin
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  15. J. Y. Hogrel
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  16. G. Butler-Browne
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  17. A. B. Maier
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Corresponding author

Correspondence to A. B. Maier.

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Bijlsma, A.Y., Meskers, C.G.M., van den Eshof, N. et al. Diagnostic criteria for sarcopenia and physical performance. AGE 36, 275–285 (2014). https://doi.org/10.1007/s11357-013-9556-5

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  • DOI: https://doi.org/10.1007/s11357-013-9556-5

Keywords

  • Sarcopenia
  • Aging
  • Mobility
  • Skeletal muscle
  • Gait speed