Abstract
Objectives
To examine the incremental value of sarcopenia components, following the diagnosis
algorithm of the Asian consensus, on predicting adverse outcomes.
Design
A prospective cohort study.
Setting and Participants
Four thousand community-dwelling Chinese adults (2000 men) aged 65 years or older
in Hong Kong (mean age = 72.5 ± 5.2).
Methods
SARC-F was used as the initial predictor of 9 adverse outcomes. In step 2, muscle
strength (ie, grip strength) and/or functions (ie, chair-stand, walking speed) were
added on top of SARC-F. In step 3, height-, weight-, and body mass index–adjusted
appendicular skeletal mass (ASM) measured by dual-energy x-ray absorptiometry (DXA)
were added separately to all models formulated in step 2. The areas under the receiver
operating characteristic curve (AUCs) were calculated for the models formulated in
all steps. Each cumulative AUC would be compared with the AUC yielded in the previous
step to evaluate the incremental prediction value.
Results
On top of SARC-F, assessing grip strength, walking speed, or 5-time chair-stand significantly
increased the AUC for most adverse outcomes. In particular, assessing both grip strength
and gait speed yielded the highest AUC in most prediction models (AUC = 0.539-0.770)
and significantly increased the AUC for all outcomes except for recurrent falls. With
both muscle strength and function assessed, adding ASM failed to significantly increase
the AUC except for 2 conditions. In the 2 conditions, however, a higher height-adjusted
ASM was associated with a higher risk of having worsened physical limitations [OR
1.25, 95% confidence interval (CI) 1.12-1.40] and decline in the physical quality
of life (OR 1.18, 95% CI 1.06-1.33) in women.
Conclusions and Implications
Assessing muscle strength and function provides additional power to predict adverse
outcomes on top of SARC-F. Further assessment of muscle mass with DXA provides no
extra constructive value ito bettering the prediction regardless of the adjustment
parameters. Alternative technologies to measure muscle mass might be required.
Keywords
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Article info
Publication history
Published online: August 05, 2020
Footnotes
This work was supported by the National Institutes of Health (grant R01-AR049439-01A1) and the Research Grants Council Earmarked (grant CUHK4101/02 M).
The authors declare no conflicts of interest.
Identification
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© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
