Peggy M Cawthon1,2, Todd Manini3, Sheena M Patel1, Anne Newman4, Thomas Travison5, Douglas P Kiel5, Adam J Santanasto4, Kristine E Ensrud6,7,8, Qian-Li Xue9, Michelle Shardell10, Kate Duchowny2, Kristine M Erlandson11, Karol M Pencina4, Roger A Fielding12, Jay Magaziner13, Timothy Kwok14, Magnus Karlsson15, Claes Ohlsson16, Dan Mellström16, Vasant Hirani17, Eva Ribom18, Rosaly Correa-de-Araujo19, Shalender Bhasin20. 1. Research Institute, California Pacific Medical Center, San Francisco, California. 2. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California. 3. University of Florida, Gainesville, Florida. 4. Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania. 5. Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts. 6. Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota. 7. Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota. 8. Department of Medicine, University of Minnesota, Minneapolis, Minnesota. 9. Division of Geriatric Medicine and Gerontology and Center on Aging and Health, Johns Hopkins Medical Institute, Baltimore, Maryland. 10. Longitudinal Studies Section, The National Institute on Aging, Baltimore, Maryland. 11. University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado. 12. Nutrition, Exercise, Physiology, and Sarcopenia Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts. 13. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland. 14. Department of Medicine & Therapeutics and School of Public Health, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Shatin, Hong Kong. 15. Department of Clinical Sciences in Malmo, Lund University, Malmo, Sweden. 16. Centre of Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 17. Charles Perkins Centre, University of Sydney, Sydney, Australia. 18. Department of surgical sciences, Orthopeadic Unit, Uppsala University, Uppsala, Sweden. 19. The National Institute on Aging, Bethesda, Maryland. 20. Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Abstract
OBJECTIVES: Analyses performed by the Sarcopenia Definitions and Outcomes Consortium (SDOC) identified cut-points in several metrics of grip strength for consideration in a definition of sarcopenia. We describe the associations between the SDOC-identified metrics of low grip strength (absolute or standardized to body size/composition); low dual-energy x-ray absorptiometry (DXA) lean mass as previously defined in the literature (appendicular lean mass [ALM]/ht2 ); and slowness (walking speed <.8 m/s) with subsequent adverse outcomes (falls, hip fractures, mobility limitation, and mortality). DESIGN: Individual-level, sex-stratified pooled analysis. We calculated odds ratios (ORs) or hazard ratios (HRs) for incident falls, mobility limitation, hip fractures, and mortality. Follow-up time ranged from 1 year for falls to 8.8 ± 2.3 years for mortality. SETTING: Eight prospective observational cohort studies. PARTICIPANTS: A total of 13,421 community-dwelling men and 4,828 community-dwelling women. MEASUREMENTS Grip strength by hand dynamometry, gait speed, and lean mass by DXA. RESULTS: Low grip strength (absolute or standardized to body size/composition) was associated with incident outcomes, usually independently of slowness, in both men and women. ORs and HRs generally ranged from 1.2 to 3.0 for those below vs above the cut-point. DXA lean mass was not consistently associated with these outcomes. When considered together, those who had both muscle weakness by absolute grip strength (<35.5 kg in men and <20 kg in women) and slowness were consistently more likely to have a fall, hip fracture, mobility limitation, or die than those without either slowness or muscle weakness. CONCLUSION: Older men and women with both muscle weakness and slowness have a higher likelihood of adverse health outcomes. These results support the inclusion of grip strength and walking speed as components in a summary definition of sarcopenia. J Am Geriatr Soc 68:1429-1437, 2020.
OBJECTIVES: Analyses performed by the Sarcopenia Definitions and Outcomes Consortium (SDOC) identified cut-points in several metrics of grip strength for consideration in a definition of sarcopenia. We describe the associations between the SDOC-identified metrics of low grip strength (absolute or standardized to body size/composition); low dual-energy x-ray absorptiometry (DXA) lean mass as previously defined in the literature (appendicular lean mass [ALM]/ht2 ); and slowness (walking speed <.8 m/s) with subsequent adverse outcomes (falls, hip fractures, mobility limitation, and mortality). DESIGN: Individual-level, sex-stratified pooled analysis. We calculated odds ratios (ORs) or hazard ratios (HRs) for incident falls, mobility limitation, hip fractures, and mortality. Follow-up time ranged from 1 year for falls to 8.8 ± 2.3 years for mortality. SETTING: Eight prospective observational cohort studies. PARTICIPANTS: A total of 13,421 community-dwelling men and 4,828 community-dwelling women. MEASUREMENTS Grip strength by hand dynamometry, gait speed, and lean mass by DXA. RESULTS: Low grip strength (absolute or standardized to body size/composition) was associated with incident outcomes, usually independently of slowness, in both men and women. ORs and HRs generally ranged from 1.2 to 3.0 for those below vs above the cut-point. DXA lean mass was not consistently associated with these outcomes. When considered together, those who had both muscle weakness by absolute grip strength (<35.5 kg in men and <20 kg in women) and slowness were consistently more likely to have a fall, hip fracture, mobility limitation, or die than those without either slowness or muscle weakness. CONCLUSION: Older men and women with both muscle weakness and slowness have a higher likelihood of adverse health outcomes. These results support the inclusion of grip strength and walking speed as components in a summary definition of sarcopenia. J Am Geriatr Soc 68:1429-1437, 2020.
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