Abstract
Objectives
Sarcopenia Definitions and Outcomes Consortium (SDOC) provides cut-points based on
muscle weakness (low grip strength) and slowness (poor gait speed) for low-risk populations;
however, it is unknown if these criteria apply to high-risk populations. We examined
the association between SDOC criteria and important health status indicators in high-risk
older persons.
Design
Cross-sectional study.
Setting and Participants
356 community-dwelling older persons (median age: 79 years, interquartile range: 73,
83; 75.2% women) attending a falls and fractures clinic in Melbourne, Australia.
Methods
Grip strength (hydraulic dynamometer) and gait speed (over 4 m) were used to define
sarcopenia using SDOC cut-points. Health measures included falls (past 1 year) and
fractures (past 5 years) by self-report, and malnutrition, depression, balance confidence,
fear of falling, static balance (limits of stability), dynamic balance (Four-Square
Step Test), and body composition [body mass index and lean mass, fat mass, and bone
density (via dual-energy x-ray absorptiometry)] were assessed using validated procedures.
Fasting vitamin D and parathyroid hormone concentrations were measured by immunoassays.
Participants were categorized as nonsarcopenic or sarcopenic based on the SDOC cut-points,
and multivariate models were used to examine the association between sarcopenia and
health status indicators while adjusting for confounding factors.
Results
After adjusting for covariates, sarcopenic older persons (n = 162, 45.5%) were positively
associated with malnutrition [odds ratio (OR) 3.21, 95% confidence interval (CI) 1.63,
6.32], depression (OR 4.11, 95% CI 2.31, 7.29), fear of falling (OR 1.08, 95% CI 1.06,
1.10) as well as recurrent (2 or more) falls (OR 1.62, 95% CI 1.01, 2.59) and fractures
(OR 2.26, 95% CI 1.17, 4.36), and negatively associated with poor balance confidence
(OR 0.96, 95% CI 0.95, 0.97) (P < .05 vs nonsarcopenic).
Conclusions and Implications
SDOC criteria are strongly associated with important health status indicators in high-risk
older persons, which strengthens the clinical utility of the SDOC in these populations.
Keywords
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References
- Welcome to the ICD-10 code for sarcopenia.J Cachexia Sarcopenia Muscle. 2016; 7: 512-514
- Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta-analysis.J Cachexia Sarcopenia Muscle. 2019; 10: 485-500
- Agreement between initial and revised European Working Group on Sarcopenia in Older People definitions.J Am Med Dir Assoc. 2019; 20: 382-383.e1
- Sarcopenia definition: The position statements of the Sarcopenia Definition and Outcomes Consortium.J Am Geriatr Soc. 2020; 68: 1410-1418
- Strong relation between muscle mass determined by D3-creatine dilution, physical performance, and incidence of falls and mobility limitations in a prospective cohort of older men.J Gerontol A Biol Sci Med Sci. 2019; 74: 844-852
- Effects of the falls and fractures clinic as an integrated multidisciplinary model of care in Australia: A pre-post study.BMJ Open. 2019; 9: e027013
- Effectiveness of the Chaos Falls Clinic in preventing falls and injuries of home-dwelling older adults: A randomised controlled trial.Injury. 2014; 45: 265-271
- Balance training using virtual reality improves balance and physical performance in older adults at high risk of falls.Clin Interv Aging. 2019; 14: 1567-1577
- Associations between osteoporosis, the severity of sarcopenia and fragility fractures in community-dwelling older adults.Eur Geriatr Med March. 2020; 11: 443-450
- The joint occurrence of osteoporosis and sarcopenia (osteosarcopenia): Definitions and characteristics.J Am Med Dir Assoc. 2020; 21: 220-225
- Development of a common outcome data set for fall injury prevention trials: The Prevention of Falls Network Europe Consensus.J Am Geriatr Soc. 2005; 53: 1618-1622
- A reference standard for the description of osteoporosis.Bone. 2008; 42: 467-475
- A new method of classifying prognostic in longitudinal studies: Development.J Chronic Dis. 1987; 40: 373-383
- The Activities-specific Balance Confidence (ABC) Scale.J Gerontol A Biol Sci Med Sci. 1995; 50: M28-M34
- Development and initial validation of the Falls Efficacy Scale–International (FES-I).Age Ageing. 2005; 34: 614-619
- The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients.Nutrition. 1999; 15: 116-122
- Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version.Clin Gerontol. 1986; 5: 119-136
- High parathyroid hormone levels are associated with poor balance in older persons: A cross-sectional study.Maturitas. 2018; 121: 57-62
- A clinical test of stepping and change of direction to identify multiple falling older adults.Arch Phys Med Rehabil. 2002; 83: 1566-1571
- Establishing the link between lean mass and grip strength cut points with mobility disability and other health outcomes: Proceedings of the Sarcopenia Definition and Outcomes Consortium Conference.J Gerontol A Biol Sci Med Sci. 2019; 75: 1317-1323
- Outcome priorities for older persons with sarcopenia.J Am Med Dir Assoc. 2020; 21: 267-271.e2
- Sarcopenia: Revised European consensus on definition and diagnosis.Age Ageing. 2019; 48: 16-31
- Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment.J Am Med Dir Assoc. 2020; 21: 300-307.e2
- Application of SDOC cut-points for low muscle strength for recovery of walking speed after hip fracture.J Gerontol A Biol Sci Med Sci April. 2020; 75: 1379-1385
- Walking speed and muscle mass estimated by the D3-creatine dilution method are important components of sarcopenia associated with incident mobility disability in older men: A classification and regression tree analysis.J Am Med Dir Assoc. 2020; 21: 1997-2002.e1
- Prevalence of sarcopenia as a comorbid disease: A systematic review and meta-analysis.Exp Gerontol. 2020; 131: 110801
- Diagnosis of sarcopenia in long-term care homes for the elderly: The sensitivity and specificity of two simplified algorithms with respect to the EWGSOP consensus.J Nutr Health Aging. 2018; 22: 796-801
- Interventions for treating sarcopenia: A systematic review and meta-analysis of randomized controlled studies.J Am Med Dir Assoc. 2017; 18: 553.e1-553.e16
- Effects of exercise and whey protein on muscle mass, fat mass, myoelectrical muscle fatigue and health-related quality of life in older adults: A secondary analysis of the Liverpool Hope University—Sarcopenia Ageing Trial (LHU-SAT).Eur J Appl Physiol. 2020; 120: 493-503
- Handgrip strength does not represent an appropriate measure to evaluate changes in muscle strength during an exercise intervention program in frail older people.Int J Sport Nutr Exerc Metab. 2015; 25: 27-36
Article info
Publication history
Published online: August 05, 2020
Footnotes
This work was supported by a Visiting Fellow Grant from the Australian Institute for Musculoskeletal Science (AIMSS) to B.K. S.L.B.-O. was supported by a National Health and Medical Research Council (NHMRC, of Australia) Career Development Fellowship (1107510). J.Z. was supported by an Australian Government Research Training Program Scholarship. E.B.H. holds an Australian Medical Research Frontiers Fund (MRFF: MACH-RART scheme 2019) Fellowship.
The authors declare no conflicts of interest.
Identification
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© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
