Peggy M Cawthon1,2, Li-Yung Lui3, Charles E McCulloch2, Jane A Cauley4, Misti L Paudel5, Brent Taylor5,6,7, John T Schousboe8,9, Kristine E Ensrud5,6,7. 1. California Pacific Medical Center, Research Institute, San Francisco. pcawthon@sfcc-cpmc.net. 2. Department of Epidemiology and Biostatistics, University of California, San Francisco. 3. California Pacific Medical Center, Research Institute, San Francisco. 4. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania. 5. Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota. 6. Department of Medicine. 7. Division of Epidemiology and Community Health, University of Minnesota, Minneapolis. 8. Park Nicollet Clinic, St. Louis Park, Minnesota. 9. Division of Health Policy and Management, University of Minnesota, Minneapolis.
Abstract
BACKGROUND: Although there are several consensus definitions of sarcopenia, their association with health care utilization has not been studied. METHODS: We included women from the prospective Study of Osteoporotic Fractures with complete assessment of sarcopenia by several definitions at the Study of Osteoporotic Fractures Year 10 (Y10) exam (1997-1998) who also had available data from Medicare Fee- For-Service Claims (N = 566) or Kaiser Encounter data (N = 194). Sarcopenia definitions evaluated were: International Working Group, European Working Group for Sarcopenia in Older Persons, Foundation for the NIH Sarcopenia Project, Baumgartner, and Newman. Hurdle models and logistic regression were used to assess the relation between sarcopenia status (the summary definition and the components of slowness, weakness and/or lean mass) and outcomes that included hospitalizations, cumulative inpatient days/year, short-term (part A paid) skilled nursing facility stay in the 3 years following the Y10 visit. RESULTS: None of the consensus definitions, nor the definition components of weakness or low lean mass, was associated with increased risk of hospitalization or greater likelihood of short-term skilled nursing facility stay. Women with slowness by any criterion definition were about 50% more likely to be hospitalized; had a greater rate of hospitalization days amongst those hospitalized; and had 1.8 to 2.1 times greater likelihood of a short-term skilled nursing facility stay than women without slowness. There was the suggestion of a protective association of low lean mass by the various criterion definitions on short-term skilled nursing facility stay. CONCLUSION: Estimated effects of sarcopenia on health care utilization were negligible. However, slowness was associated with greater health care utilization.
BACKGROUND: Although there are several consensus definitions of sarcopenia, their association with health care utilization has not been studied. METHODS: We included women from the prospective Study of Osteoporotic Fractures with complete assessment of sarcopenia by several definitions at the Study of Osteoporotic Fractures Year 10 (Y10) exam (1997-1998) who also had available data from Medicare Fee- For-Service Claims (N = 566) or Kaiser Encounter data (N = 194). Sarcopenia definitions evaluated were: International Working Group, European Working Group for Sarcopenia in Older Persons, Foundation for the NIH Sarcopenia Project, Baumgartner, and Newman. Hurdle models and logistic regression were used to assess the relation between sarcopenia status (the summary definition and the components of slowness, weakness and/or lean mass) and outcomes that included hospitalizations, cumulative inpatient days/year, short-term (part A paid) skilled nursing facility stay in the 3 years following the Y10 visit. RESULTS: None of the consensus definitions, nor the definition components of weakness or low lean mass, was associated with increased risk of hospitalization or greater likelihood of short-term skilled nursing facility stay. Women with slowness by any criterion definition were about 50% more likely to be hospitalized; had a greater rate of hospitalization days amongst those hospitalized; and had 1.8 to 2.1 times greater likelihood of a short-term skilled nursing facility stay than women without slowness. There was the suggestion of a protective association of low lean mass by the various criterion definitions on short-term skilled nursing facility stay. CONCLUSION: Estimated effects of sarcopenia on health care utilization were negligible. However, slowness was associated with greater health care utilization.
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