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Methodological Issues and the Impact of Age Stratification on the Proportion of Participants with Low Appendicular Lean Mass When Adjusting for Height and Fat Mass Using Linear Regression: Results from the Canadian Longitudinal Study on Aging

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Abstract

Background

Using residual values calculated from models regressing appendicular lean mass on fat mass and height is one of several suggested strategies for adjusting appendicular lean mass for body size when measuring sarcopenia. However, special consideration is required when using this technique in different subgroups in order to capture the correct individuals as sarcopenic.

Objectives

To provide guidance about how to conduct stratified analyses for the regression adjustment technique using age groups as an example.

Design

Cross-sectional study.

Setting

Data collected at baseline (2012–2015) for the Canadian Longitudinal Study on Aging.

Participants

Community dwelling participants of European descent aged 45 to 85 years (n=25,399).

Measurements

Appendicular lean mass, height, and weight were measured. Sex-specific residuals were calculated in participants before and after stratifying participants by age group (45–54, 55–64, 65–74, 75–85 years). Cut offs corresponding to the sex-specific 20th percentile residual values in participants ≥65 years were determined first in the residuals calculated in all participants and residuals calculated in only those aged ≥65 years. For each set of cut offs, the percentage of age and sex-stratified participants with low appendicular lean mass were compared for the residuals calculated in all participants and the residuals calculated after stratifying by age.

Results

In 12,622 males and 12,737 females, regardless of the cut off used, the percentage of participants with low appendicular lean mass decreased with age when residuals were calculated after age stratification. When the residuals were calculated in all participants, the percentage of participants with sarcopenia increased from the youngest to the oldest age groups.

Conclusions

Sex-specific residuals in all participants should be calculated prior to stratifying the sample by age group, or other stratification variables, for the purposes of developing appendicular lean mass cut offs or subgroup analyses.

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Acknowledgements

This research was made possible using the data/biospecimens collected by the Canadian Longitudinal Study on Aging (CLSA). Funding for the Canadian Longitudinal Study on Aging (CLSA) is provided by the Government of Canada through the Canadian Institutes of Health Research (CIHR) under grant reference: LSA 94473 and the Canada Foundation for Innovation. This research has been conducted using the CLSA dataset, Baseline Comprehensive Dataset version 4.0, under Application Number 160608. The CLSA is led by Drs. Parminder Raina, Christina Wolf son and Susan Kirkland. The opinions expressed in this manuscript are the author’s own and do not reflect the views of the Canadian Longitudinal Study on Aging.

Funding

No funding to report.

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Authors and Affiliations

  1. Department of Health Research Methods, Evidence, and Impact, McMaster University, MTP 309A, 175 Longwood Road South, Hamilton, Ontario, L8P 0A1, Canada

    A. J. Mayhew, N. Sohel, L. Thabane, R. J. De Souza & Parminder Raina

  2. Labarge Centre for Mobility in Aging, Hamilton, Ontario, Canada

    A. J. Mayhew, N. Sohel & Parminder Raina

  3. McMaster Institute for Research on Aging, Hamilton, Ontario, Canada

    A. J. Mayhew, N. Sohel & Parminder Raina

  4. Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada

    S. M. Phillips & G. Parise

  5. Biostatistics Unit, Research Institute at St Joes, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada

    L. Thabane

  6. Department of Mathematics & Statistics, McMaster University, Hamilton, Ontario, Canada

    P. D. McNicholas

  7. Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada

    R. J. De Souza

Authors
  1. A. J. Mayhew
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  2. S. M. Phillips
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  3. N. Sohel
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  4. L. Thabane
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  5. P. D. McNicholas
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  6. R. J. De Souza
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  7. G. Parise
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  8. Parminder Raina
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Contributions

AJM, SMP, and PR conceptualized this project with feedback from NS, LT, PDM, RJd and GP. AJM and NS completed the analysis of the data. AJM, NS, and PR interpreted the results. AJM completed the draft of the manuscript with revisions from the remaining authors. All authors provided approval for the final version to be published and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Parminder Raina.

Ethics declarations

Ethics approval for this project was received by the Hamilton Research Ethics Board (#2686).

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Conflict of interest

None declared

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Mayhew, A.J., Phillips, S.M., Sohel, N. et al. Methodological Issues and the Impact of Age Stratification on the Proportion of Participants with Low Appendicular Lean Mass When Adjusting for Height and Fat Mass Using Linear Regression: Results from the Canadian Longitudinal Study on Aging. J Frailty Aging 10, 150–155 (2021). https://doi.org/10.14283/jfa.2020.48

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  • DOI: https://doi.org/10.14283/jfa.2020.48

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