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The longitudinal associations of sarcopenia definitions with functional deterioration: a comparative study

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Abstract

Objective

Probable sarcopenia is a predictor of functional limitation in older adults. However, whether standard thresholds recommended by guides, or population-specific thresholds better predict impairment in functionality is an issue that needs to be enlightened. We aimed to study the associations of probable sarcopenia identified by the use of EWGSOP2 and population-specific thresholds with deterioration in functionality at follow-up and give prevalences of probable sarcopenia with different thresholds in older outpatients admitted to a tertiary health center.

Methods

In this retrospective, longitudinal follow-up study, we assessed handgrip strength (HGS) at the admission with a Jamar hand-dynamometer and diagnosed probable sarcopenia with standard and population-specific thresholds, i.e., 27 kg/16 kg, and 35 kg/20 kg in males/females, respectively. We evaluated activities of daily living (ADL) and instrumental ADL (IADL), with Katz and Lawton scales, at the admission and follow-up. To study whether probable sarcopenia was a predictor of impaired functionality, we defined two models for Cox regression analysis. We performed adjustments for age, sex, and nutritional status (assessed by Mini-Nutritional Assessment-Short Form) in Model 1 and defined Model 2 by adding low gait speed and frailty to the variables in Model 1.

Results

Among a total of 1970 patients, 195 had follow-up of median 560 days. The mean age was 75.5 ± 5.5, and 142 (72.8%) were female. In the basal evaluation, the prevalences of probable sarcopenia defined by the standard cut-offs and by population-specific cut-offs were 8.7% and 35.4%, respectively. In univariate analyses (Kaplan–Meier log-rank test), probable sarcopenia by population-specific cut-offs, but not EWGSOP2-cut-offs, was associated with deteriorations in both ADL (p = 0.04) and IADL (p < 0.001). In multivariate analyses, only the probable sarcopenia identified by population-specific cut-offs was independently associated with impairment in IADL in both models [HR (95%CI) = 1.88 (1.07–3.30), and 1.9 (1.04–3.6); for Model 1 and Model 2, respectively)].

Conclusion

Our findings suggested that the definition of probable sarcopenia identified by not standard, but population-specific thresholds more reliably predicted longitudinal deterioration of functionality in older outpatients. This finding might be considered as evidence supporting the use of population-specific cut-offs when the concern is sarcopenia diagnosis.

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Data availability

The datasets generated during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to warmly thank Meryem Merve Oren for her contributions to the statistical analysis of this study.

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Authors and Affiliations

  1. Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, Istanbul, Turkey

    Gulistan Bahat, Meris Esra Bozkurt, Serdar Ozkok, Cihan Kilic & Mehmet Akif Karan

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  2. Meris Esra Bozkurt
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  3. Serdar Ozkok
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Contributions

Conceptualization and data curation were contributed by GB and MEB. Formal analysis, investigation, and methodology were contributed by GB, CK, SO, and MEB. Project administration, resources, software, supervision, validation, visualization, writing—original draft, and writing—review and editing, were contributed by all authors.

Corresponding author

Correspondence to Gulistan Bahat.

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Conflict of interest

The authors declare no conflict of interest. The data were previously presented orally at the annual meeting of the World Congress on Osteoporosis, Osteoarthritis, and Musculoskeletal Diseases on March 24–27, 2022.

Ethical approval

Ethical approval for the study was granted by the local ethics committee (reference: 1586/2020).

Human and animal rights statement

The study design and all procedures involving human participants were in accordance with the ethical standards of the institutional research committee as well as the 1964 Helsinki Declaration and its subsequent amendments.

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Written informed consent was obtained from all participants.

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Bahat, G., Bozkurt, M.E., Ozkok, S. et al. The longitudinal associations of sarcopenia definitions with functional deterioration: a comparative study. Aging Clin Exp Res 35, 2089–2099 (2023). https://doi.org/10.1007/s40520-023-02498-5

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