Abstract
BackgroundThe operational definition of sarcopenia has been updated (EWGSOP2) and apply different cut-off points compared to previous criteria (EWGSOP1). Therefore, we aim to compare the sarcopenia prevalence and the association with mortality and dependence in activities of daily living using the 2010 (EWGSOP1 and 2019 (EWGSOP2 operational definition, applying cut-offs at two levels using T-scores.MethodsTwo birth cohorts, 70 and 85-years-old (n = 884 and n = 157, respectively), were assessed cross-sectionally (57% women). Low grip strength, low muscle mass and slow gait speed were defined below − 2.0 and − 2.5 SD from a young reference population (T-score). Muscle mass was defined as appendicular lean soft tissue index by DXA. The EWGSOP1 and EWGSOP2 were applied and compared with McNemar tests and Cohen’s kappa. All-cause mortality was analyzed with the Cox-proportional hazard model.ResultsSarcopenia prevalence was 1.4–7.8% in 70-year-olds and 42–62% in 85 years-old’s, depending on diagnostic criteria. Overall, the prevalence of sarcopenia was 0.9–1.0 percentage points lower using the EWGSOP2 compared to EWGSOP1 when applying uniform T-score cut-offs (P < 0.005). The prevalence was doubled (15.0 vs. 7.5%) using the − 2.0 vs. -2.5 T-scores with EWGSOP2 in the whole sample. The increase in prevalence when changing the cut-offs was 5.7% (P < 0.001) in the 70-year-olds and 17.8% (P < 0.001) in the 85-year-olds (EWGSP2). Sarcopenia with cut-offs at − 2.5 T-score was associated with increased mortality (hazard ratio 2.4–2.8, P < 0.05) but not at T-score − 2.0.ConclusionsThe prevalence of sarcopenia was higher in 85-year-olds compared to 70-year-olds. Overall, the differences between the EWGSOP1 and EWGSOP2 classifications are small. Meaningful differences between EWGSOP1 and 2 in the 85-year-olds could not be ruled out. Prevalence was more dependent on cut-offs than on the operational definition.
Highlights
According to the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopenia can be defined as the combination of low muscle mass and poor muscle function [1, 2]
There is a lack of knowledge about how EWGSOP1 and 2 impact the prevalence of sarcopenia that is distinct from applying different cut-offs
Cut-offs as originally published by the EWGSOP 1 and 2 were applied for comparison, except for hand grip strength were a cut-off of − 2.5 T-scores were applied, since no cutoffs for the Martin Vigorimeter have been published by the EGWSOP, Table 3 [1, 2]. In this way we studied the impact of the EWGSOP 1 and 2 operational definitions, with the same cut-offs, and the impact of different cut-off points on the prevalence of sarcopenia
Summary
According to the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopenia can be defined as the combination of low muscle mass and poor muscle function [1, 2]. There is a lack of knowledge about how EWGSOP1 and 2 impact the prevalence of sarcopenia that is distinct from applying different cut-offs. The objective of this study was, to cross-sectionally compare the difference of the EWGSOP1 and 2 operational definitions on sarcopenia prevalence, applying cut-offs based on T-scores at two levels (− 2.0 and − 2.5) in two population-based samples of 70 and 85-year-olds from Gothenburg, Sweden. The operational definition of sarcopenia has been updated (EWGSOP2) and apply different cut-off points compared to previous criteria (EWGSOP1). We aim to compare the sarcopenia prevalence and the association with mortality and dependence in activities of daily living using the 2010
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