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Abstract
Background: The European Working Group on Sarcopenia has recently proposed revised cut-off values for the definition of low grip strength (EWGSOP2). We therefore compared performance of the EWGSOP2 cut-off definition of low grip strength with other internationally used cut-off points in a sample of older patients. Methods: We analyzed geriatric assessment data in a cross-sectional sample of 98 older patients admitted to a post-acute care hospital. First, we compared prevalence of sarcopenia and frailty phenotype in our sample using low grip strength cut-points from the EWGSOP2 and seven other internationally used consensus statements. Second, we calculated correlations between low grip strength and two independent surrogate outcomes (i.e., gait speed, and the clinical frailty scale) for the EWGSOP2 and the other seven cut-point definitions. Results: Prevalence of sarcopenia based on the EWGSOP2 grip strength cut-off values was significantly lower (10.2%) than five of the seven other cut-point definitions (e.g., 19.4% based on Sarcopenia Definitions and Outcomes Consortium (SDOC) criteria). Similarly, frailty phenotype prevalence was significantly lower based on EWGSOP2 cut-points (57.1%) as compared to SDOC (70.4%). The correlation coefficient of gait speed with low grip strength based on EWGSOP2 cut-points was lower (0.145) as compared to other criteria (e.g., SDOC 0.240). Conclusions: Sarcopenia and frailty phenotype were identified considerably less using the EWGSOP2 cut-points for low grip strength, potentially underestimating prevalence of sarcopenia and frailty phenotype in post-acute hospital patients.
Highlights
Sarcopenia and physical frailty are clinical syndromes occurring in older patients associated with adverse outcomes such as mobility impairment, fracture, functional impairment, and mortality [1,2]
We investigated correlations between different low grip strength cut-point with independent outcomes of sarcopenia and frailty (clinical frailty scale (CFS))
We found that within a sample of post-acute hospital patients, the prevalence estimates of sarcopenia and frailty phenotype based on the EWGSOP2 cut-off definition of low grip strength were significantly lower than estimates obtained from other recommended cut-off definitions
Summary
Sarcopenia and physical frailty are clinical syndromes occurring in older patients associated with adverse outcomes such as mobility impairment, fracture, functional impairment, and mortality [1,2]. It is important to identify sarcopenia and frailty in older patients for implementing targeted interventions to prevent adverse clinical outcomes. In the diagnostic work-up of sarcopenia, frailty grip strength is a core determinant as a proxy measurement for overall muscle strength. Working Group on Sarcopenia in Older People (EWGSOP2), low grip strength is the primary parameter together with low muscle mass to diagnose sarcopenia [4]. Low grip strength is one of the five criteria, along with shrinking, exhaustion, slowness, and low activity, for defining the Fried frailty phenotype [5]
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