Abstract
Objectives
Both sarcopenia and physical frailty are geriatric syndromes causing loss of functionality
and independence. This study explored the association between sarcopenia and physical
frailty and the overlap of their criteria in older people living in different community
(care) settings. Moreover, it investigated the concurrent validity of the FRAIL scale
to assess physical frailty, by comparison with the widely used Fried criteria.
Design
Data were retrieved from the cross-sectional Maastricht Sarcopenia Study (MaSS).
Setting
The study was undertaken in different community care settings in an urban area (Maastricht)
in the south of the Netherlands.
Participants
Participants were 65 years or older, gave written informed consent, were able to understand
Dutch language, and were not wheelchair bound or bedridden.
Intervention
Not applicable.
Measurements
Sarcopenia was identified using the algorithm of the European Working Group on Sarcopenia
in Older People. Physical frailty was assessed by the Fried criteria and by the FRAIL
scale. Logistic regression was performed to assess the association between sarcopenia
and physical frailty measured by the Fried criteria. Spearman correlation was performed
to assess the concurrent validity of the FRAIL scale compared with the Fried criteria.
Results
Data from 227 participants, mean age 74.9 years, were analyzed. Sarcopenia was identified
in 23.3% of the participants, when using the cutoff levels for moderate sarcopenia.
Physical frailty was identified in 8.4% (≥3 Fried criteria) and 9.3% (≥3 FRAIL scale
criteria) of the study population. Sarcopenia and physical frailty were significantly
associated (P = .022). Frail older people were more likely to be sarcopenic than those who were
not frail. In older people who were not frail, the risk of having sarcopenia increased
with age. Next to poor grip strength (78.9%) and slow gait speed (89.5%), poor performance
in other functional tests was common in frail older people. The 2 physical frailty
scales were significantly correlated (r = 0.617, P < .001).
Conclusion
Sarcopenia and physical frailty were associated and partly overlap, especially on
parameters of impaired physical function. Some evidence for concurrent validity between
the FRAIL scale and Fried criteria was found. Future research should elicit the value
of combining sarcopenia and frailty measures in preventing disability and other negative
health outcomes.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the American Medical Directors AssociationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- In search of an integral conceptual definition of frailty: Opinions of experts.J Am Med Dir Assoc. 2010; 11: 338-343
- Searching for an operational definition of frailty: A Delphi method based consensus statement: The frailty operative definition-consensus conference project.J Gerontol A Biol Sci Med Sci. 2013; 68: 62-67
- Sarcopenia: An undiagnosed condition in older adults: Current consensus definition: Prevalence, etiology, and consequences. International working group on sarcopenia.J Am Med Dir Assoc. 2011; 12: 249-256
- Prevalence of frailty in community-dwelling older persons: A systematic review.J Am Geriatr Soc. 2012; 60: 1487-1492
- Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People.Age Ageing. 2010; 39: 412-423
- Frailty consensus: A call to action.J Am Med Dir Assoc. 2013; 14: 392-397
- Frailty and its prediction of disability and health care utilization: The added value of interviews and physical measures following a self-report questionnaire.Arch Gerontol Geriatr. 2012; 55: 369-379
- Fighting sarcopenia in older frail subjects: Protein fuel for strength, exercise for mass [letter].J Am Med Dir Assoc. 2013; 14: 140-143
- Frailty in elderly people.Lancet. 2013; 381: 752-762
- Frailty and muscle metabolism dysregulation in the elderly.Biogerontology. 2010; 11: 527-536
- Sarcopenia: A useful paradigm for physical frailty.Eur Geriatr Med. 2013; 4: 102-105
- Influence of sarcopenia and functionality indicators on the frailty profile of community-dwelling elderly subjects: A cross-sectional study.Braz J Phys Ther. 2013; 17: 373-381
- The frailty phenotype and the frailty index: Different instruments for different purposes.Age Ageing. 2014; 43: 10-12
- Frailty in older adults: Evidence for a phenotype.J Gerontol A Biol Sci Med Sci. 2001; 56: M146-M156
- A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans.J Nutr Health Aging. 2012; 16: 601-608
- Untangling the concepts of disability, frailty, and comorbidity: Implications for improved targeting and care.J Gerontol A Biol Sci Med Sci. 2004; 59: 255-263
- A comparison of two approaches to measuring frailty in elderly people.J Gerontol A Biol Sci Med Sci. 2007; 62: 738-743
- Bioelectrical impedance analysis: Part II: Utilization in clinical practice.Clin Nutr. 2004; 23: 1430-1453
- Estimation of skeletal muscle mass by bioelectrical impedance analysis.J Appl Physiol. 2000; 89: 465-471
- Rationale and design of a cross-sectional study of the prevalence, characterization and health and economic consequences of sarcopenia in community-dwelling older people in the Netherlands [abstract].J Nutr Health Aging. 2013; 17: S245
- Validity and reliability of tools to measure muscle mass, strength, and physical performance in community-dwelling older people: A systematic review.J Am Med Dir Assoc. 2013; 14: 170-178
- Skeletal muscle cutpoints associated with elevated physical disability risk in older men and women.Am J Epidemiol. 2004; 159: 413-421
- A short physical performance battery assessing lower extremity function: assocation with self-reported disability and prediction of mortality and nursing home admission.J Gerontol Med Sci. 1994; 49: M85-M94
- Validation of the frail scale in a cohort of older Australian women.J Am Geriatr Soc. 2012; 60: 171-173
- Comprehensive evaluation of the Minnesota Leisure Time Physical Activity Questionnaire.J Clin Epidemiol. 1994; 47: 271-281
- A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation.J Chronic Dis. 1987; 40: 373-383
- “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician.J Psychiatr Res. 1975; 12: 189-198
- The assessment of disability with the Groningen Activity Restriction Scale: Conceptual framework and psychometric properties.Soc Sci Med. 1996; 43: 1601-1610
- Quality criteria were proposed for measurement properties of health status questionnaires.J Clin Epidemiol. 2007; 60: 34-42
- Sarcopenia risk screening tool: A new strategy for clinical practice.J Am Med Dir Assoc. 2014; 15: 613-614
- Sarcopenia: There is a need for some steps forward.J Am Med Dir Assoc. 2014; 15: 379-380
- Validating the SARC-F: A suitable community screening tool for sarcopenia?.J Am Med Dir Assoc. 2014; 15: 630-634
- The FNIH sarcopenia project: Rationale, study description, conference recommendations, and final estimates.J Gerontol A Biol Sci Med Sci. 2014; 69: 547-558
- Counteracting the trajectory of frailty and sarcopenia in older adults.Nutr Clin Pract. 2014; 29: 428-434
- Severe osteopenia and osteoporosis, sarcopenia, and frailty status in community-dwelling older women: Results from the Women's Health and Aging Study (WHAS) II.Bone. 2011; 48: 952-957
- The selection of a screening test for frailty identification in community-dwelling older adults.J Nutr Health Aging. 2014; 18: 199-203
- The integration of frailty into clinical practice: Preliminary results from the Gerontopole.J Nutr Health Aging. 2012; 16: 714-720
- The prevalence of frailty syndrome in an older population from Spain: The Toledo Study for Healthy Aging.J Nutr Health Aging. 2011; 15: 852-856
- Frailty among community-dwelling elderly people in France: The three-city study.J Gerontol A Biol Sci Med Sci. 2008; 63: 1089-1096
- Description of 1,108 older patients referred by their physician to the “Geriatric Frailty Clinic (G.F.C) for Assessment of Frailty and Prevention of Disability” at the gerontopole.J Nutr Health Aging. 2014; 18: 457-464
- The ability of three different models of frailty to predict all-cause mortality: Results from the European Male Aging Study (EMAS).Arch Gerontol Geriatr. 2013; 57: 360-368
- Comparison of frailty indicators based on clinical phenotype and the multiple deficit approach in predicting mortality and physical limitation.J Am Geriatr Soc. 2012; 60: 1478-1486
- Frailty and sarcopenia: Definitions and outcome parameters.Osteoporos Int. 2012; 23: 1839-1848
- Musculoskeletal frailty: A geriatric syndrome at the core of fracture occurrence in older age.Calcif Tissue Int. 2012; 91: 161-177
- Sarcopenia and physical frailty: Two sides of the same coin.Front Aging Neurosci. 2014; 6: 192
- From sarcopenia to frailty: A road less traveled.J Cachexia Sarcopenia Muscle. 2014; 5: 5-8
- Implementing frailty into clinical practice: We cannot wait.J Nutr Health Aging. 2012; 16: 599-600
- The frailty dilemma: Review of the predictive accuracy of major frailty scores.Eur J Intern Med. 2012; 23: 118-123
- Evidence-based recommendations for optimal dietary protein intake in older people: A position paper from the PROT-AGE Study Group.J Am Med Dir Assoc. 2013; 14: 542-559
- New strategies for the concurrent strength-, power-, and endurance-training prescription in elderly individuals.J Am Med Dir Assoc. 2013; 14: 623-624
- Sarcopenia and mortality risk in frail older persons aged 80 years and older: Results from ilSIRENTE study.Age Ageing. 2013; 42: 203-209
- Identifying sarcopenia in acute care setting patients.J Am Med Dir Assoc. 2014; 15: 303.e307-303.e312
- Prevalence of sarcopenia in geriatric hospitalized patients.J Am Med Dir Assoc. 2014; 15: 267-272
- Outcome instruments to measure frailty: A systematic review.Ageing Res Rev. 2011; 10: 104-114
Article info
Publication history
Published online: December 16, 2014
Footnotes
The authors declare no conflicts of interest.
Nutricia Research supported the Maastricht Sarcopenia Study with an unrestricted grant.
Identification
Copyright
© 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
