Abstract
Introduction
Frailty and sarcopenia are correlates of musculoskeletal aging that represent a state
of vulnerability increasing the risk of negative health outcomes. Standardized definitions
are lacking for both, and sometimes both concepts are used interchangeably. However,
no large study has assessed the coexistence of these 2 entities in a cohort of older
community-dwelling people.
Methods
Data were taken from the Toledo Study of Healthy Aging (TSHA), a study of community-dwelling
elderly (≥65 years). The study population consists of 1611 participants with frailty
and sarcopenia assessments. For sarcopenia, we used 3 criteria: European Working Group
on Sarcopenia in Older People (EWGSOP), the Foundation for the National Institutes
of Health (FNIH), and the FNIH fitted to the cut-off points of our population [standardized
FNIH (sFNIH)]. Frailty was assessed according to the Fried criteria with cut-off points
adjusted to our population. We used logistic regression to assess the relationship
between sarcopenia and frailty and measures of diagnostic accuracy to evaluate the
potential use of sarcopenia as a diagnostic marker for frailty.
Results
The mean age of the population was 75.42 years (±5.86). Overall, 72 (4.5%) were frail.
In addition, 352 (21.8%), 332 (20.6%), and 453 (28.1%) participants were considered
sarcopenic according to the EWGSOP, FNIH, and sFNIH criteria, respectively. The prevalence
of frailty among those with sarcopenia was 8.2% (29/352), 15.7% (52/332), and 10.4%
(47/453). Moreover, among frail people, the prevalence of sarcopenia was 40.27%, 72.2%,
and 65.3% according to the used criteria. Sarcopenia showed a low sensitivity (<10%)
but high specificity (>97%) for the diagnosis of frailty, with a low intercorrelation
(Cramer V = 0.16, 0.40, and 0.30) between the 3 criteria and frailty. Using multivariate
logistic regression, frailty was associated with sarcopenia according to EWGSOP [odds
ratio (OR) = 1.67, 95% confidence interval (CI) = 0.95, 2.96], FNIH (OR = 10.61, 95%
CI = 5.8, 19.4), and sFNIH (OR = 6.63, 95% CI =3.5, 12.53).
Conclusion
Frailty and sarcopenia are distinct but related conditions. Sarcopenia is not a useful
clinical biomarker of frailty, but its absence might be useful to exclude frailty.
Keywords
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Article info
Publication history
Published online: October 24, 2017
Footnotes
The authors declare no conflicts of interest.
This study was supported by Grants CIBERFES (CB16/10/00464) and Fondos FEDER; FRAILOMIC Project (FP7-Health-2012-Innovation-1, contract number 305483).
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© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
