Abstract
Objectives
The updated definition of sarcopenia by the European Working Group on Sarcopenia in
Older People (EWGSOP2) recommends both low muscle mass and quality to diagnose sarcopenia;
concurrent poor physical performance is considered indicative of severe sarcopenia;
however, the relationship between the revised definition and disability incidence
among Japanese older adults is unclear. Therefore, we aimed to examine the associations
between EWGSOP2-defined sarcopenia and disability incidence among community-dwelling
older Japanese adults.
Design
Nationwide study.
Setting and participants
We included 4561 individuals aged ≥65 years and enrolled in the National Center for
Geriatrics and Gerontology–Study of Geriatric Syndromes (NCGG-SGS).
Methods
Skeletal muscle mass was assessed using a bioimpedance analysis device; handgrip strength
and walking speed were measured as physical performance indicators. We used the Asian
Working Group for Sarcopenia cutoffs to define low muscle mass and poor physical performance.
We stratified all participants into nonsarcopenia, sarcopenia, and severe sarcopenia
groups. Disability incidence was prospectively determined over 49 months using data
extracted from the Japanese long-term care insurance system.
Results
The prevalence of sarcopenia and severe sarcopenia was 3.4% and 1.7%, respectively.
Participants with any form of sarcopenia were at a higher risk of disability [hazard
ratio (HR) 1.78, 95% confidence interval (CI) 1.27-2.49]. Although participants with
severe sarcopenia showed a higher risk of disability (HR 2.00, 95% CI 1.32-3.02),
there was no significant disability risk in the sarcopenia group (HR 1.54, 95% CI
0.97-2.46). Grip strength (HR 0.96, 95% CI 0.94-0.98) and walking speed (HR 0.19,
95% CI 0.12-0.30) negatively correlated with disability incidence.
Conclusions and implications
Severe sarcopenia, involving low muscle mass and poor physical performance, might
increase disability risk in older adults, as opposed to low muscle mass alone. Further
studies are needed to determine whether sarcopenia without poor physical performance
increases disability risk.
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
- Influence of sarcopenia on the development of physical disability: The Cardiovascular Health Study.J Am Geriatr Soc. 2006; 54: 56-62
- Sarcopenia is associated with disability status—Results from the KORA-Age study.Osteoporos Int. 2017; 28: 2069-2079
- FNIH-defined sarcopenia predicts adverse outcomes among community-dwelling older people in Taiwan: Results from I-Lan longitudinal aging study.J Gerontol A Biol Sci Med Sci. 2018; 73: 828-834
- Sarcopenia.Best Pract Res Clin Rheumatol. 2017; 31: 218-242
- Exercise training as a treatment for chronic inflammation in the elderly.Exerc Sport Sci Rev. 2009; 37: 165-170
- 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: 300-307e302
- Combined prevalence of frailty and mild cognitive impairment in a population of elderly Japanese people.J Am Med Dir Assoc. 2013; 14: 518-524
- Predicting elderly people's risk for nursing home placement, hospitalization, functional impairment, and mortality: a synthesis.Med Care Res Rev. 2000; 57: 259-297
- Using two different algorithms to determine the prevalence of sarcopenia.Geriatr Gerontol Int. 2014; 14: 46-51
- Development of an equation for estimating appendicular skeletal muscle mass in Japanese older adults using bioelectrical impedance analysis.Geriatr Gerontol Int. 2014;
- Care-needs certification in the long-term care insurance system of Japan.J Am Geriatr Soc. 2005; 53: 522-527
- "Mini-Mental State.” A practical method for grading the cognitive state of patients for the clinician.J Psychiatr Res. 1975; 12: 189-198
- Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version.Clin Gerontol. 1986; 5: 165-173
- Validation of the Geriatric Depression Scale–Short Form among inpatients.J Clin Psychol. 1994; 50: 256-260
- Risk factors for functional status decline in community-living elderly people: A systematic literature review.Soc Sci Med. 1999; 48: 445-469
- Predictors for functional decline among nondisabled older Japanese living in a community during a 3-year follow-up.J Am Geriatr Soc. 2000; 48: 1424-1429
- Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies.Lancet. 2004; 363: 157-163
- Prevalence of sarcopenia defined using the Asia Working Group for Sarcopenia criteria in Japanese community-dwelling older adults: A systematic review and meta-analysis.Phys Ther Res. 2019; 22: 53-57
- The prevalence of sarcopenia in community-dwelling older adults, an exploration of differences between studies and within definitions: a systematic review and meta-analyses.Age Ageing. 2019; 48: 48-56
- Sarcopenia prevalence and risk factors among Japanese community dwelling older adults living in a snow-covered city according to EWGSOP2.J Clin Med. 2019; 8
- EWGSOP2 versus EWGSOP1: Impact on the prevalence of sarcopenia and its major health consequences.J Am Med Dir Assoc. 2019; 20: 384-385
- Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women.J Am Geriatr Soc. 2007; 55: 769-774
- Epidemiology of sarcopenia among the elderly in New Mexico.Am J Epidemiol. 1998; 147: 755-763
- Lower extremity function and subsequent disability: Consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery.J Gerontol A Biol Sci Med Sci. 2000; 55: M221-231
- Prognostic value of usual gait speed in well-functioning older people—Results from the Health, Aging and Body Composition Study.J Am Geriatr Soc. 2005; 53: 1675-1680
- Added value of physical performance measures in predicting adverse health-related events: Results from the Health, Aging And Body Composition Study.J Am Geriatr Soc. 2009; 57: 251-259
- Measures of physical performance and risk for progressive and catastrophic disability: Results from the Women's Health and Aging Study.J Gerontol A Biol Sci Med Sci. 2005; 60: 74-79
- Physical performance measures in the clinical setting.J Am Geriatr Soc. 2003; 51: 314-322
- Mobility limitation in self-described well-functioning older adults: Importance of endurance walk testing.J Gerontol A Biol Sci Med Sci. 2008; 63: 841-847
- Walking speed as a good predictor for the onset of functional dependence in a Japanese rural community population.Age Ageing. 2000; 29: 441-446
- Lower body function and mortality in Mexican American elderly people.J Gerontol A Biol Sci Med Sci. 2001; 56: M243-247
- Gait speed and survival in older adults.JAMA. 2011; 305: 50-58
- Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older.J Gerontol A Biol Sci Med Sci. 2005; 60: 1304-1309
- Cardiovascular disease, interleukin-6, and risk of mortality in older women: The Women's Health and Aging Study.Circulation. 2001; 103: 947-953
- Fall-related factors and risk of hip fracture: the EPIDOS prospective study.Lancet. 1996; 348: 145-149
- Sarcopenia-related parameters and incident disability in older persons: Results from the "Invecchiare in Chianti" study.J Gerontol A Biol Sci Med Sci. 2015; 70: 457-463
- Incidence of disability in frail older persons with or without slow walking speed.J Am Med Dir Assoc. 2015; 16: 690-696
- Prevalence of sarcopenia and associated factors in institutionalised older adult patients.Clin Nutr ESPEN. 2018; 27: 113-119
- Frailty in older adults: Evidence for a phenotype.J Gerontol A Biol Sci Med Sci. 2001; 56: M146-156
- Muscle mass, strength, and physical performance predicting activities of daily living: A meta-analysis.J Cachexia Sarcopenia Muscle. 2020; 11: 3-25
- Predictive values of the new sarcopenia index by the Foundation for the National Institutes of Health Sarcopenia Project for Mortality among Older Korean Adults.PLoS One. 2016; 11: e0166344
Article info
Publication history
Published online: November 21, 2020
Footnotes
This work was supported by the Health Labour Sciences Research Grants from the Japanese Ministry of Health, Labour and Welfare, Japan (grant H23-tyoujyu-ippan-001); the Research Funding for Longevity Sciences from the National Center for Geriatrics and Gerontology (NCGG), Japan (grants 22-16 and 26-33); the Obu City Local Government, Japan; and a Grant-in-Aid for Scientific Research (B), Japan (grant 23300205). The funding source played no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.
Identification
Copyright
© 2020 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
