Abstract
BackgroundOperational definitions of sarcopenia, i.e. loss of muscle function and mass, have been proposed by the European Working Group on Sarcopenia in Older People (EWGSOP) and the Foundation for the National Institutes of Health Sarcopenia Project (FNIH). The aim of this study was to analyse the prevalence and outcome, i.e. all-cause mortality and hospitalisation, of sarcopenia and its diagnostic components in octogenarian community-dwelling men.MethodsIn total 287 men, aged 85–89 y, participating in the Uppsala Longitudinal Study of Adult Men (ULSAM) underwent Dual X-ray Absorptiometry (DXA), measurement of hand grip strength (HGS), gait speed (GS), and a five-times chair stand test (CS). Sarcopenia and probable sarcopenia were defined according to EWGSOP (2010), EWGSOP2 (2018), and FNIH (2014). All-cause mortality and hospitalisations over 3 years were registered.ResultsSarcopenia according to EWGSOP, EWGSOP2 and FNIH was observed in 21%, 20%, and 8% of the men, respectively, while probable sarcopenia (EWGSOP2; eq. reduced muscle strength only) was seen in 73%. “Sarcopenia (EWGSOP)” and “probable sarcopenia (EWGSOP2)” were associated with increased mortality (HR 1.95, 95% CI 1.12–3.40 and HR 3.26, 95% CI 1.38–7.70, respectively). “Probable sarcopenia (EWGSOP2)” was associated with days of hospitalisation (RR 2.12, 95% CI 1.36–3.30), whereas sarcopenia according to FNIH showed an association with the number of hospitalisations (RR 1.75, 95% CI 1.10–2.81).ConclusionsIn very old men, reduced muscle strength, i.e. probable sarcopenia, was common and associated with mortality and length of stay during hospitalisation. When combined with low muscle mass (according to DXA), i.e. sarcopenia, the various definitions were associated more weakly with the adverse outcomes. The findings support the emphasis on reduced muscle strength as the major determinant of sarcopenia.
Highlights
Operational definitions of sarcopenia, i.e. loss of muscle function and mass, have been proposed by the European Working Group on Sarcopenia in Older People (EWGSOP) and the Foundation for the National Institutes of Health Sarcopenia Project (FNIH)
EWGSOP has recently updated this operational definition of sarcopenia (EWGSOP2), where the emphasis is shifted towards muscle strength
Mean body mass index (BMI) was 25.6 kg/m2 (SD 3.4) and 12% (n = 35) displayed BMI < 22 kg/m2, which is an indication of underweight
Summary
Operational definitions of sarcopenia, i.e. loss of muscle function and mass, have been proposed by the European Working Group on Sarcopenia in Older People (EWGSOP) and the Foundation for the National Institutes of Health Sarcopenia Project (FNIH). In 2010 the European Working Group on Sarcopenia in Older People (EWGSOP) defined sarcopenia as reduced muscle mass (adjusted for height) combined with low muscle strength (hand grip strength) and/or low physical performance (gait speed). Using a somewhat different approach the Foundation for the National Institutes of Health Sarcopenia Project (FNIH), in 2014 published cut-points for weakness, slowness, and low lean mass that were based on analyses of several cohorts of community-dwelling older persons [9]. FNIH uses appendicular lean mass with the recommendation to adjust for body mass index (BMI); low grip strength to define weakness; and low gait speed to define slowness
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