Abstract
Dysmobility syndrome is a newly proposed concept to comprehensively consider bone-muscle-adiposity as a whole to associate with mortality and other adverse outcomes in the older adults. Little was known in Asian populations since the body composition was highly related to ethnicity. The study aimed to evaluate the association between dysmobility syndrome and mortality and to explore the most optimal operational definition for dysmobility syndrome. The prevalence of dysmobility syndrome was 3.9–10.1% based on different operational definitions of adiposity and skeletal muscle index. Subjects with dysmobility syndrome were older, more often to be women, having higher adiposity, lower lean body mass and bone mineral density. Multivariate Cox proportional hazard model showed that dysmobility and pre-dysmobility syndrome had higher risk of mortality than the robust group (Hazard ratio (HR): 11.3, 95% confidence interval (CI): 1.2–109.1; and HR 8.7, 95% CI 1.1-67.3, respectively). Overall, the modified operational definition of dysmobility syndrome in Asian populations using FNIH-adjusted skeletal muscle mass and waist circumference-defined adiposity may be the most optimal model for mortality prediction. Taking the nexus of body composition as a whole to evaluate the mortality risk of older adults is an important improvement beyond sarcopenia and osteoporosis.
Highlights
Epidemiological studies have shown the interrelated associations between muscle strength, walking speed, sarcopenia, osteoporosis, body fat composition and mortality among older adults[1,2,3,4,5]
The FNIH criteria proposed using body mass index (BMI) for the adjustment of skeletal muscle index to harmonize the definition of muscle index[7], which may result in bigger discrepancy in Asian populations
The number of components for dysmobility syndrome significantly increased with advancing age (p for trend < 0.001) (Fig. 2)
Summary
Epidemiological studies have shown the interrelated associations between muscle strength, walking speed, sarcopenia, osteoporosis, body fat composition and mortality among older adults[1,2,3,4,5]. A recent study identified substantial differences in the prevalence of dysmobility syndrome and associated falls by using proposed definitions of skeletal muscle mass by www.nature.com/scientificreports/. The European Working Group for Sarcopenia in Older People (EWGSOP), the International Working Group on Sarcopenia (IWGS) and the Foundation for the National Institutes of Health Sarcopenia Project (FNIH)[14]. These differences may be even more significant in Asia due to higher adiposity of Asian people than Caucasians, especially in women[15]. Dysmobility syndrome proposed the comprehensive approach of bone-muscle-adiposity to health of older people, and the association between dysmobility syndrome and adverse health outcomes has been established in some studies[12]. The main aim of this study intended to use a prospective population-based cohort to examine the association between dysmobility syndrome and mortality and to refine the operational definition of dysmobility syndrome through the outcome-based approach
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