Handgrip Strength Cut-off Points Research Articles

Association between low handgrip strength and incontinence among Chinese middle-aged and older people: A cross-sectional study.

Incontinence seriously affects the lives of middle-aged and older people. Pelvic floor muscle assessment is very important for incontinence, and handgrip strength can be used as an auxiliary diagnostic tool. Our study aims to find new cutoff points of handgrip strength as early indicators of incontinence and analyze the association between low handgrip strength and incontinence among Chinese middle-aged and older people. Participants were recruited from the 2015 China Health and Retirement Longevity Study. Receiver operating characteristic (ROC) curves were used to find the handgrip strength cutoff point. Logistic regression analysis was performed to explore other incontinence-related risk factors. The study included 10,229 middle-aged and older people. Compared with normal handgrip strength participants, medium strength participants had 1.510 [men, 95% confidence interval (CI) = 1.017-2.243] and 1.792 (women, 95% CI = 1.294-2.480) times greater risk of incontinence, and low strength participants had 2.420 (men, 95% CI = 1.787-3.277) and 1.516 (women, 95% CI = 1.130-2.032) times greater risk of incontinence. Trend test results showed that the risk of incontinence increased with decreasing handgrip strength in middle-aged and older people. Our study suggests that handgrip strength < 31 kg in men and < 20.5 kg in women is significantly associated with higher risk of incontinence in Chinese middle-aged and older people. The risk of incontinence increases with decreasing handgrip strength. Handgrip strength should be measured in routine physical examinations in middle-aged and older people for timely assessment and intervention in incontinence.

Should knee extension strength testing be implemented as a screening test for identifying probable and confirmed sarcopenia in older T2DM patients?

BackgroundThe accelerated loss of muscle strength and mass observed in older type 2 diabetes mellitus (T2DM) patients due to the combined effects of diabetes and obesity, greatly increases their risk for sarcopenia. Early detection and treatment of probable and confirmed sarcopenia is paramount to delay mobility disability. Using low handgrip strength cut-off points for the initial identification of sarcopenia according to the new European Working Group on Sarcopenia in Older People (EWGSOP2) guidelines may mask the presence of sarcopenia. Relative knee extension strength cut-off points using a simple hand-held dynamometer can assist clinicians in the diagnosis of probable and confirmed sarcopenia by possibly reducing false negative results.MethodsA cohort of one hundred T2DM older patients (60% women) (mean age 74.5 years) mostly obese community dwelling older adults were evaluated for body composition by Bioelectrical impedance analysis (BIA), yielding appendicular skeletal mass index (ASMI) results. Patients underwent handgrip strength (HGS) and knee extension strength (KES) tests as well as functional ability tests. Prevalence of probable and confirmed sarcopenia using HGS and KES cut-off points were calculated. Pearson correlations were performed to evaluate the relationship between ASMI and limbs strength. A regression analysis was conducted to examine which variables best predict ASMI values. A multivariate analysis of covariance was performed to assess the effect of independent variables on KES and HGS.ResultsUsing cutoff points for low KES identified 24 patients with probable sarcopenia and two with confirmed sarcopenia. Conversely, using the EWGSOP2 cut off points for low HGS, identified only one patient with probable sarcopenia and none of the patients with confirmed sarcopenia.ConclusionKES cut-off points using a simple hand-held dynamometer can assist in the identification of probable and confirmed sarcopenia using EWGSOP2 cut off points for low muscle mass in a population of older T2DM patients for further analysis and early treatment. This is notably true in patients possessing high body mass index (BMI) alongside normal ASMI and HGS, potentially reducing false positive sarcopenia screening results.Trial registrationClinicalTrials.gov PRS: NCT03560375. Last registration date (last update): 06/06/2018. The trial was a-priori registered before actual recruitment of subjects.

Allometrically adjusted handgrip strength and chair stand test cut points to identify sarcopenia in older Portuguese adults

ABSTRACT Absolute muscle strength or adjusted by body mass index (BMI) are useful to identify sarcopenia. However, these values are not accurate for older adults with extreme body sizes because the nonlinear relationship between strength and body size. The purpose was to determine cut-off points for identify sarcopenia in older adults using allometric coefficients to normalise handgrip strength (HGS) and 30-sec chair stand test (30-s CST) by body size. Allometric exponents were proposed with log-linear models for body-size variables (body mass, height and BMI). The remotion of body-size effect on muscle strength with allometric normalisation was tested by partial correlation. Cut-off points for low muscle strength were established by ROC curve and Youden index considering functional limitation (six-minute walk test&lt;400m). Allometric exponents provided for body-size variables range from -0.01 to 2.28 (HGS) and -0.27 to 0.21 (30-s CST). The effect of body size on muscle strength was removed with allometric normalisation (r&lt;0.30). Cut-off points accuracy was always adequate (AUC≥0.78; p&lt;0.001). In conclusion, cut-off points of HGS and 30-s CST allometrically normalised were proposed to identify sarcopenia in Portuguese older adults and allometry maintained adequate the accuracy (AUC&gt;70%). Allometry removed influence of body size on the expression of HGS and 30-s CST and permits evaluate muscle strength regardless of body-size.

Handgrip Strength Cutoff Points for Functional Independence and Wheelchair Ability in Men With Spinal Cord Injury.

To determine optimal handgrip strength (HGS) cutoff points for greater functional independence and wheelchair skills in men with spinal cord injury (SCI), and to establish predictive equations for functional independence and wheelchair ability in men with SCI, based on demographic characteristics, HGS, and functionality. In this cross-sectional study conducted at a rehabilitation hospital, 54 men with SCI were recruited and stratified into high and low paraplegia groups. All participants performed a maximum HGS test to determine cutoff points for the Spinal Cord Independence Measure (SCIM-III) and Adapted Manual Wheelchair Circuit (AMWC). The primary outcomes were the SCIM-III, AMWC, and HGS. Demographic characteristics obtained from participants' electronic medical records were the secondary outcomes, used as predictor variables of functional independence. The SCIM-III scale, performance score, and 3-minute overground wheeling test presented significant regression equations (R = 0.45, R = 0.69, and R = 0.72). The HGS showed a cutoff point of 102.5 kilogram force (kgf) to achieve a score of 70 on the SCIM-III and a 3-minute overground wheeling distance of 270 m. The HGS cutoff point to obtain a performance score of 23.7 seconds was 93.0 kgf. The HGS was a significant predictor for the SCIM-III score, AMWC performance score, and 3-minute overground wheeling test. Three significant predictive equations were established based on HGS. The cutoff points could be adopted as parameters for optimal functional independence and wheelchair skills.

Association between handgrip strength and cognition in a Chinese population with Alzheimer\u2019s disease and mild cognitive impairment

BackgroundThis study aimed to explore the level and changes in handgrip strength among preclinical Alzheimer’s disease (AD) and AD patients and to evaluate the association between handgrip strength and cognitive function.MethodsA total of 1431 participants from the memory clinic of Shanghai JiaoTong University Affiliated Sixth People’s Hospital and community were enrolled in the final analysis, including 596 AD, 288 mild cognitive impairment (MCI), and 547 normal individuals (NC). All participants received a comprehensive neuropsychological assessment. Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment-Basic (MoCA-BC), and the Chinese version of Addenbrooke’s Cognitive Examination III (ACE-III-CV) were used as cognitive tests. The receiver operating characteristic curve (ROC) was plotted to assess the power of handgrip strength as a screening measure to discriminate AD and MCI.ResultsThe results showed that handgrip strength in the MCI group was significantly lower than that of NC group, and the AD group had a further decline (both P < 0.01). Multivariate logistic regression was performed with the handgrip strength quartiles, and the results showed that the ORs of AD for increasing levels of handgrip strength were 1.00, 0.58 (0.46–0.78), 0.51 (0.36–0.73), and 0.50 (0.35–0.68), showing a decreasing trend (Pfor trend < 0.01). The ROC curve demonstrated that the handgrip strength cutoff points for the identification of AD were 16.8 and 20.7 kg among the female participants above and under 70 yrs and 24.4 and 33.3 kg for the male participants above and under 70 yrs, respectively. Similarly, for the identification of MCI, cutoff points were 17.5 and 21.9 kg for females above 70 yrs and under 70 yrs, and 25.8 and 36.2 kg for males above 70 yrs and under 70 yrs, respectively.ConclusionsOur study provided the further knowledge on the relationship between noncognitive features and cognition in populations with differing cognitive status, revealed that the stronger handgrip strength was associated with better performances on cognitive function. It can be speculated that handgrip strength can help early recognition of Chinese AD patients.

Handgrip strength cut-off points for early detection of cardiometabolic risk in Chilean children

The aim of this study was to determine whether handgrip strength is associated with cardiometabolic risk in children. The secondary aim was to establish sex-specific handgrip strengthcut-off points for early detection of cardiometabolic risk. A total sample of 452 Chilean children (267 girls and 185 boys) aged 7-9 years old was analyzed. Muscle fitness was measured by an adjustable dynamometer and normalized by body mass (i.e., handgrip strength/body mass). Sex-specific cardiometabolic risk scores were computed as the sum of the waist-to-height ratio (Equation 1) or waist circumference (Equation 2) and insulin, triglycerides, high-density lipoproteins, and glycemia levels. Receiver operating curve (ROC) analyses were performed to identify those with cardiometabolic risk scores > 1 standard deviation above the mean. ROC analyses showed a significant discriminating accuracy of normalized handgrip strength in identifying cardiometabolic risk in boys (≤ 0.33) and girls (≤ 0.40) using both equations. The highest sensitivity was offered by Equation 2 for boys [46%; 95% CI (32-59%)] and for girls [71%; 95% CI (60-80)]. The greatest specificity was alsooffered by Equation 2 for boys [82%; 95% CI (74-88)] and girls [63%; 95% CI (55-70)]. Since the values obtained by ROC analyses are low (especially in boys), caution is warranted regarding the strength of the existing evidence base.Conclusion: Thesespecific cut-off points according to sex for possible cardiometabolic risk could be used by Chilean health professionals and school staff as an initial assessment in the field setting. What is known • There is strong evidence for the importance of muscular fitness during childhood and adolescence for cardiometabolic risk. • There has been no research to establish minimum handgrip strength capacity levels to predict cardiometabolic risk among Chilean children. What is new • Cut-off points for handgrip strength relative to body mass to identify cardiometabolic risk in Chilean children are 0.33 in boys and 0.40 in girls. • The early use of these cut-off points and its appropriate identification could have benefits of preventive and diagnostic therapeutic intervention and as a starting point to define adequate levels of handgrip strength.

Accuracy of different handgrip values to identify mobility limitation in older adults

Background/ObjectiveMobility limitation is commonly the first sign of impaired physical function and predisposes older adults to disability. Moreover, recent epidemiological studies have classified neuromuscular strength as the best explanator of mobility limitation. However, existing cutoffs have not been adequately analyzed regarding accuracy. Therefore, our aims were to define and compare the accuracy of different cutoff points of handgrip strength for the identification of mobility limitation. MethodsCross-sectional study with 5783 participants from the SABE (Saúde, Bem-Estar e Envelhecimento [Health, Wellbeing and Aging]) and ELSA (English Longitudinal Study of Ageing) cohorts aged 60 years or older. Handgrip strength was measured using a dynamometer. Walking speed <0.8 m/s was considered mobility limitation. Receiver operating characteristic curves and probabilities of presenting mobility limitation were calculated. ResultsHandgrip strength <32 kg for men and <21 kg for women demonstrated good diagnostic accuracy for mobility limitation, with 49.1% sensitivity and 79.8% specificity for men and 58.6% sensitivity and 72.9% specificity for women. The fully adjusted models had an area under the curve of 0.82 for men and 0.83 for women, with odds of presenting mobility limitation of 1.88 [95% CI: 1.50 – 2.37] for men and 1.89 [95% CI: 1.57 - 2.27] for women. ConclusionsThe results of this study support the accuracy of handgrip strength as a clinical marker of mobility limitation. Furthermore, manual dynamometry is easily incorporated into clinical practice, has a good cost-benefit, besides being a simple, valid, reliable and effective method for use in both the scientific community and outpatient practice.

Comparison of standard versus population-specific handgrip strength cut-off points in the detection of probable sarcopenia after launch of EWGSOP2

Objective We aimed to compare European Working Group on Sarcopenia in Older People (EWGSOP2)-suggested and population-specific handgrip strength (HGS) thresholds to detect probable sarcopenia and their associations with physical-performance measures and frailty. Methods A retrospective cross-sectional observational-study included geriatrics outpatients applied to a university-hospital. HGS, timed up and go test (TUG), and usual gait speed (UGS) were assessed. Frailty was screened by FRAIL-scale. Results A total of 1825 older adults were included (mean age, 74.5 + 7.0 years; 68.8% female). Prevalence of low-HGS were 12.2% by the EWGSOP2-recommended (27/16 kg) cut-offs and 37.5% by population-specific cut-offs (35/20 kg) (p<.001). When low-HGS was defined by EWGSOP2 suggested cut-offs, low-HGS was associated with impaired UGS, (odds ratio [OR] = 3.8, 95% confidence interval [CI]: 2.0–6.9, p<.001); impaired TUG, (OR = 4.6, 95% CI: 2.4–8.8, p<.001); and frailty (OR = 20.9, 95% CI: 8.3–53.0, p<.001). Similarly, low HGS determined by population-specific cut-off points was associated with impaired UGS (OR = 3.1, 95% CI: 2.1–6.9, p<.001); impaired TUG (OR = 6.0, 95% CI: 3.0–11.8, p<.001); and frailty (OR = 7.3, 95% CI: 4.1–13.0, p<.001). Conclusions Application of EWGSOP2-recommended standard HGS-cut-offs showed successful application in-practice. However, use of standard HGS cut-offs may result in underdiagnosis of probable sarcopenia. Therefore, we suggest that, whenever available, use of population-specific cut-offs for HGS may be better for correctly identifying older adults at risk.

The cut-off values of handgrip strength and lean mass index for sarcopenia among patients on peritoneal dialysis

BackgroundSarcopenia is common and contributes to a high risk of mortality among general population. There is no consensus regarding the cut-off values for sarcopenia in terms of mortality among chronic kidney disease patients. This study aimed to explore and validate cut-off points of handgrip strength (HGS) and lean mass index (LMI) for estimating the risk of mortality in peritoneal dialysis (PD) patients.MethodsThis single-center prospective cohort study enrolled 1089 incident PD patients between October 2002 and July 2019. All patients were followed until death, transfer to hemodialysis, receiving renal transplantation or the end date of study (December 2019). All participants were randomly sampled to development cohort (70% participants) and validation cohort (30% participants), matched by gender and diabetes. Lean body mass was calculated by using the equation published by our center. Cubic spline regression analysis was used to examine the relationship between HGS or LMI values and mortality, and explore the cut-off points after adjusting for age, diabetes, cardiovascular disease and serum albumin in the development cohort. The derived cut-off values were verified by the agreement rate for predicting mortality and then compared with cut-off values from various clinical guidelines in the validation cohort.ResultsAll 1089 patients were followed up with the median of 36.0 (18.0, 71.0) months. In the development cohort, cut-off points for predicting the higher mortality were derived as 24.5 kg and 14 kg of HGS for males and females, 16.7 kg/m2 and 13.8 kg/m2 of LMI for males and females respectively. In the validation cohort, these cut-off values significantly predicted worse outcomes, with HR 1.96 (1.35, 2.84) of HGS and HR 1.76 (1.26, 2.47) of LMI for all-cause mortality after multivariate adjustment. The newly derived cut-off points of HGS have numerically higher prognostic values in all-cause mortality compared with those from current clinical guidelines, and agreement rates of HGS were 65.2 versus 62.5–64.6 respectively.ConclusionsThe derived cut-off values of HGS and LMI have sufficient and better prognostic value in predicting all-cause mortality in PD patients compared with the cut-off values in the existing guidelines. These cut-off values are only validated in a single population, thus limiting the generalizability.

Association of handgrip strength with the prevalence of metabolic syndrome in US adults: the national health and nutrition examination survey.

Objective: Aimed to find the cut-off point of handgrip strength and it’s association with MetS.Results: The relative handgrip strength was negatively associated with the prevalence of MetS. Of note, the odds ratios (ORs) with 95% confidence intervals (CIs) across tertiles of relative handgrip strength were 1 (reference), 0.45 (0.33, 0.62), and 0.13 (0.08, 0.20) in male participants after adjusting for demographic factors, calorie intake, and physical activity. Similar results were observed in female participants. The cutoff values of relative handgrip strength for male and female participants were 0.52 and 0.40, respectively.Conclusions: Findings of this study suggest that a strong relationship exists between handgrip strength and prevalence of MetS in US adults, regardless of sex.Methods: A total of 5 056 participants in the National Health and Nutrition Examination Survey were analysed in this study. Handgrip strength was measured by using a handgrip dynamometer. MetS was defined in accordance with the criteria of the scientific statement of the American Heart Association in 2009. Multivariable binary logistic regression was used to explore the association between handgrip strength and MetS.

Handgrip Strength Cut-Off Values for the Undernutrition Risk Screening among Elderly Men and Women in Bosnia and Herzegovina.

Objectives To determine the optimal cut-off points of handgrip strength (HGS) to identify the undernutrition risk among individuals older than 65 years of age in Bosnia and Herzegovina. Design Cross-sectional study. Setting Towns of Sarajevo, Foca, Rogatica, and Pale in Bosnia and Herzegovina. Participants 300 community-dwelling older adults and 146 nursing home residents. Comprehensive Geriatric multidimensional assessment (CGA) was carried out to evaluate general health, functional, and cognitive capabilities. Nutritional status and undernutrition risk were assessed by Mini Nutritional Assessment (MNA) and Seniors in the Community: risk evaluation for eating and nutrition, version II (SCREEN II). HGS was measured with a Smedley dynamometer. Results According to the classification of nutritional status by MNA, 42% of community-dwelling men and 39% of community-dwelling women were at undernutrition risk. The undernutrition risk was significantly higher among nursing home residing men (89%) and women (78%) (p < 0.001). When nutritional status was assessed by SCREEN II, 100% on nursing home residents, 86% of community-dwelling men and 80% of women were identified as having a high risk for undernutrition. Per MNA, HGS cut-off thresholds were 23.50 kgF (65–74 years) and 19.50 kgF (≥75 years) for men; 15.50 kgF (65–74 years) and 13.50 kgF (≥75 years) for women. Per SCREEN II, cut-points were 28.50 kgF (65–74 years) and 24.50 kgF (≥75 years) for men; 24.50 kgF (65–74 years), 19.50 kgF (≥75 years for women). Conclusion HGS can be a useful instrument to identify undernutrition risk among the elderly patients. This study provides threshold for men and women older than 65 years of age in Bosnia and Herzegovina.

Application of hand grip strength as a screening tool for frailty in patients with liver cirrhosis

Objective To explore the cutoff points of handgrip strength and its predictive value in frailty assessment in hospitalised patients with cirrhosis. Methods By convenient sampling, the cirrhosis patients admitted to the Department of Gastroenterology of a ClassⅢ Grade A hospital from March 2017 to April 2018 were selected and studied. Fried frailty phenotype was used as the standard reference, and the receiver operating characteristic curve (ROC) was calculated to determine the best cutoff points of handgrip strength, hence evaluate its predictive value. Results A total of 80 questionnaires were distributed in which 73 valid ones were retrieved with a effective recovery rate of 91.25%. Among the patients, 40 patients (54.8%) were identified to be at frailty stage and 33 patients (45.2%) were in non-frailty stage; the handgrip strength was (19.72±3.50) kg, which had a negative correlation with age and neutrophil lymphocyte ratio (P<0.05) ; at the same time, it was positively correlated with serum albumin and walking speed (P< 0.05) . The area under the ROC curve of male and female cirrhosis patients was 0.734 and 0.863 respectively, and the optimal cut-off points were 18.95 kg and 15.03 kg; the sensitivity, specificity, positive predictive value and negative predictive value were 95.00%, 81.82%, 86.36%, and 93.10%. Conclusions When the grip strength of male and female patients were less than or equal to 18.95 kg and 15.03 kg respectively, it indicates that he or she is in a frailty state. Handgrip strength test can be a quick screening tool to identify frailty in inpatients with cirrhosis, and it has high predictive value, and is time-efficient, easy to use, therefore it can be applied in clinical practice. Key words: Liver cirrhosis; Frailty assessment; Handgrip strength; Cut-off point

Reference values for handgrip strength and their association with intrinsic capacity domains among older adults.

ObjectiveThe purposes of this study were three‐fold: (i) to describe handgrip strength in older individuals aged ≥60 years in Colombia; (ii) to identify sex‐specific and age‐specific muscle weakness cut‐off points in older adults; and (iii) to determine the odds of adverse events for each of the intrinsic capacity domains for individuals with handgrip strength greater than the muscle weakness cut‐off points, as compared with their weaker counterparts.MethodsA cross‐sectional study was conducted in Colombia, among 5237 older adults aged ≥60 years old (58.5% women, 70.5 ± 7.8 years), according to ‘SABE Survey 2015’. Handgrip strength data were obtained with a Takei dynamometer. Sociodemographic variables, five domains of intrinsic capacity (i.e. locomotion, vitality, cognition, psychological, and sensory), and medical conditions were assessed and analyzed. Adjustments variables were age, ethnicity, socio‐economic status, urbanicity, body mass index, smoking status, alcohol intake, drug use, physical activity, and co‐morbid chronic diseases. Sex‐stratified analyses were conducted with logistic regression models.ResultsHandgrip strength was greater among men than among women (26.7 ± 8.5 vs. 16.7 ± 5.7 kg, respectively, P < 0.001) at all ages. Weak handgrip strength cut‐off points ranged from 17.4 to 8.6 and from 10.1 to 4.9 in men and women, respectively. Overall, participants with optimal handgrip strength had better intrinsic capacity [in men, odds ratio (OR) = 0.62, 95% confidence interval (CI) 0.53 to 0.71; P < 0.001; and in women, OR = 0.79, 95% CI 0.68 to 0.92; P = 0.002] than their weaker counterparts. Also, men with optimal handgrip strength had a lower risk of hospitalization (OR = 0.47, 95% CI 0.29 to 0.78; P = 0.004) than their weaker counterparts.ConclusionsThis study is the first to describe handgrip strength values and cut‐off points for muscle weakness among a nationally representative sample of Colombian older adults by age and sex. After categorizing older adults as weak or not weak based on the handgrip cut‐off points, non‐weakness was associated with a decreased odds of intrinsic capacity impairments. These cut‐off points may be good candidates for clinical assessment of risks to physical and mental health in older Colombian adults.

Handgrip Strength Cutoff Points to Identify Mobility Limitation in Community-dwelling Older People and Associated Factors.

Sarcopenia is defined as a progressive and generalized loss of skeletal muscle mass and strength. The specific threshold of muscle weakness that leads to mobility limitations has not been identified. To determine the best cutoff point of handgrip strength for identifying mobility limitation and to investigate the factors associated with muscle weakness and mobility limitation in community-dwelling older people. Transversal study. Cities of Belo Horizonte, Barueri and Santa Cruz in Brazil. 1374 community-dwelling older people from the Frailty study in Brazilian older people (FIBRA Study). Outcomes included muscle weakness determined according to gender-specific handgrip strength cutoff points generated by Receiver Operating Characteristic curves, mobility limitation defined as a gait speed ≤ 0.8 m/s; and a combination of both muscle weakness and mobility limitation. Associated factors included socio-demographic variables, lifestyle, anthropometrics, health conditions, use of health services and disability. The cutoff points of handgrip strength with the best balancing between sensitivity and specificity for mobility limitation were 25.8 kgf for men (sensitivity 69%, specificity 73%) and 17.4 kgf (sensitivity 60%, specificity 66%) for women. Age and disability in instrumental activities of daily living were associated with all outcomes. Women had greater odds of mobility limitation than men. Physical inactivity, body fat, diabetes, depression, sleeping disturbances, number of medications and occurrence of falls remained as significant associated factors in the final model. Handgrip strength can be a useful tool to identify mobility limitation in clinical practice. Interventions to prevent or minimize impacts of sarcopenia should stimulate physical activity and improvement of body composition in addition to the management of chronic diseases and disabilities.

Epidemiology of sarcopenia among community‐dwelling older adults in Taiwan: A pooled analysis for a broader adoption of sarcopenia assessments

To develop cut-off points of muscle mass, gait speed and handgrip strength; and to examine the prevalence of sarcopenia, and the relationship between sarcopenia stages and functional limitations and disability by using these cut-off points. We pooled individual participant data of 2867 community-dwelling older adults from five cohort studies. We defined the cut-off point of a muscle mass index (ASM/ht(2)) as the values of two standard deviations below the sex-specific means of a young population or as the 20th percentile of the sex-specific distribution in our study population. The gait speed and handgrip strength cut-off points were defined as the 20th percentile of their population distributions. We also measured functional limitations, using the Short Physical Performance Battery, and the number of activities of daily living and instrumental activities of daily living difficulties. We identified the cut-off points of ASM/ht(2), gait speed and handgrip strength. By applying these cut-off points to our study population, the prevalence of sarcopenia varied from 3.9% (2.5% in women and 5.4% in men) to 7.3% (6.5% in women and 8.2% in men). A higher sarcopenia stage was independently associated with a lower summary performance score, as well as more activities of daily living and instrumental activities of daily living difficulties (P < 0.05 for all). The prevalence of sarcopenia in community-dwelling older adults is comparable with those in other populations. A dose-response relationship exists between sarcopenia stages and functional limitations/disability. The European Working Group on Sarcopenia in Older People consensus definition using these cut-off points is suitable for determining sarcopenia cases in the elderly population of Taiwan.