Shalender Bhasin1, Thomas G Travison2, Todd M Manini3, Sheena Patel4, Karol M Pencina1, Roger A Fielding5, Jay M Magaziner6, Anne B Newman7, Douglas P Kiel2, Cyrus Cooper8, Jack M Guralnik6, Jane A Cauley7, Hidenori Arai9, Brian C Clark10, Francesco Landi11, Laura A Schaap12, Suzette L Pereira13, Daniel Rooks14, Jean Woo15, Linda J Woodhouse16, Ellen Binder17, Todd Brown18, Michelle Shardell19, Quian-Li Xue20, Ralph B DʼAgostino21, Denise Orwig6, Greg Gorsicki22, Rosaly Correa-De-Araujo23, Peggy M Cawthon4. 1. Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 2. Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School, Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts. 3. Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida. 4. California Pacific Medical Center Research Institute, San Francisco Coordinating Center, San Francisco, California. 5. Nutrition, Exercise, Physiology, and Sarcopenia Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts. 6. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland. 7. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania. 8. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. 9. National Center for Geriatrics and Gerontology, Obu, Japan. 10. Department of Biomedical Sciences, Division of Geriatric Medicine, Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, Ohio. 11. Department of Medicine and geriatrics, Catholic University of Sacred Heart, Rome, Italy. 12. Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research institute, Amsterdam, The Netherlands. 13. Abbott Nutrition, Abbott Laboratories, Chicago, Illinois. 14. Muscle Group, Translational Medicine, Novartis Institutes for Biomedical Research, Cambridge, Massachusetts. 15. CUHK Jockey Club Institute of Ageing, SH Ho Centre for Gerontology and Geriatrics, The Chinese University of Hong Kong, Shatin, Hong Kong. 16. Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada. 17. Division of Geriatrics, Washington University School of Medicine, St. Louis, Missouri. 18. Division of Endocrinology, Diabetes, & Metabolism, Johns Hopkins University, Baltimore, Maryland. 19. Epidemiology and Public Health, Longitudinal Studies Section, National Institute on Aging, Baltimore, Maryland. 20. Division of Geriatric Medicine and Gerontology and Center on Aging and Health, Johns Hopkins Medical Institute, Baltimore, Maryland. 21. Department of Mathematics, Framingham Heart Study, Boston University, Boston, Massachusetts. 22. Department of Kinesiology, Georgia Southern University. 23. Division of Geriatrics and Clinical Gerontology, National Institute on Aging, Bethesda, Maryland.
Abstract
OBJECTIVES: To develop an evidence-based definition of sarcopenia that can facilitate identification of older adults at risk for clinically relevant outcomes (eg, self-reported mobility limitation, falls, fractures, and mortality), the Sarcopenia Definition and Outcomes Consortium (SDOC) crafted a set of position statements informed by a literature review and SDOC's analyses of eight epidemiologic studies, six randomized clinical trials, four cohort studies of special populations, and two nationally representative population-based studies. METHODS: Thirteen position statements related to the putative components of a sarcopenia definition, informed by the SDOC analyses and literature synthesis, were reviewed by an independent international expert panel (panel) iteratively and voted on by the panel during the Sarcopenia Position Statement Conference. Four position statements related to grip strength, three to lean mass derived from dual-energy x-ray absorptiometry (DXA), and four to gait speed; two were summary statements. RESULTS: The SDOC analyses identified grip strength, either absolute or scaled to measures of body size, as an important discriminator of slowness. Both low grip strength and low usual gait speed independently predicted falls, self-reported mobility limitation, hip fractures, and mortality in community-dwelling older adults. Lean mass measured by DXA was not associated with incident adverse health-related outcomes in community-dwelling older adults with or without adjustment for body size. CONCLUSION: The panel agreed that both weakness defined by low grip strength and slowness defined by low usual gait speed should be included in the definition of sarcopenia. These position statements offer a rational basis for an evidence-based definition of sarcopenia. The analyses that informed these position statements are summarized in this article and discussed in accompanying articles in this issue of the journal. J Am Geriatr Soc 68:1410-1418, 2020.
OBJECTIVES: To develop an evidence-based definition of sarcopenia that can facilitate identification of older adults at risk for clinically relevant outcomes (eg, self-reported mobility limitation, falls, fractures, and mortality), the Sarcopenia Definition and Outcomes Consortium (SDOC) crafted a set of position statements informed by a literature review and SDOC's analyses of eight epidemiologic studies, six randomized clinical trials, four cohort studies of special populations, and two nationally representative population-based studies. METHODS: Thirteen position statements related to the putative components of a sarcopenia definition, informed by the SDOC analyses and literature synthesis, were reviewed by an independent international expert panel (panel) iteratively and voted on by the panel during the Sarcopenia Position Statement Conference. Four position statements related to grip strength, three to lean mass derived from dual-energy x-ray absorptiometry (DXA), and four to gait speed; two were summary statements. RESULTS: The SDOC analyses identified grip strength, either absolute or scaled to measures of body size, as an important discriminator of slowness. Both low grip strength and low usual gait speed independently predicted falls, self-reported mobility limitation, hip fractures, and mortality in community-dwelling older adults. Lean mass measured by DXA was not associated with incident adverse health-related outcomes in community-dwelling older adults with or without adjustment for body size. CONCLUSION: The panel agreed that both weakness defined by low grip strength and slowness defined by low usual gait speed should be included in the definition of sarcopenia. These position statements offer a rational basis for an evidence-based definition of sarcopenia. The analyses that informed these position statements are summarized in this article and discussed in accompanying articles in this issue of the journal. J Am Geriatr Soc 68:1410-1418, 2020.
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