Putative Cut-Points in Sarcopenia Components and Incident Adverse Health Outcomes: An SDOC Analysis

Peggy M. Cawthon; Todd Manini; Sheena M. Patel; Anne Newman; Thomas Travison; Douglas P. Kiel; Adam J. Santanasto; Kristine E. Ensrud; Qian Li Xue; Michelle Shardell; Kate Duchowny; Kristine M. Erlandson; Karol M. Pencina; Roger A. Fielding; Jay Magaziner; Timothy Kwok; Magnus Karlsson; Claes Ohlsson; Dan Mellström; Vasant Hirani; Eva Ribom; Rosaly Correa-de-Araujo; Shalender Bhasin

doi:10.1111/jgs.16517

Putative Cut-Points in Sarcopenia Components and Incident Adverse Health Outcomes: An SDOC Analysis

Peggy M. Cawthon, Todd Manini, Sheena M. Patel, Anne Newman, Thomas Travison, Douglas P. Kiel, Adam J. Santanasto, Kristine E. Ensrud, Qian Li Xue, Michelle Shardell, Kate Duchowny, Kristine M. Erlandson, Karol M. Pencina, Roger A. Fielding, Jay Magaziner, Timothy Kwok, Magnus Karlsson, Claes Ohlsson, Dan Mellström, Vasant HiraniEva Ribom, Rosaly Correa-de-Araujo, Shalender Bhasin

Medicine - Veteran's Administration Medical Center

Research output: Contribution to journal › Article › peer-review

129 Scopus citations

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.

Original language	English (US)
Pages (from-to)	1429-1437
Number of pages	9
Journal	Journal of the American Geriatrics Society
Volume	68
Issue number	7
DOIs	https://doi.org/10.1111/jgs.16517
State	Published - Jul 1 2020

Bibliographical note

Publisher Copyright:
© 2020 The American Geriatrics Society

Keywords

gait speed
grip strength
hip fracture
mobility limitation
sarcopenia

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10.1111/jgs.16517

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Cawthon, P. M., Manini, T., Patel, S. M., Newman, A., Travison, T., Kiel, D. P., Santanasto, A. J., Ensrud, K. E., Xue, Q. L., Shardell, M., Duchowny, K., Erlandson, K. M., Pencina, K. M., Fielding, R. A., Magaziner, J., Kwok, T., Karlsson, M., Ohlsson, C., Mellström, D., ... Bhasin, S. (2020). Putative Cut-Points in Sarcopenia Components and Incident Adverse Health Outcomes: An SDOC Analysis. Journal of the American Geriatrics Society, 68(7), 1429-1437. https://doi.org/10.1111/jgs.16517

Cawthon, PM, Manini, T, Patel, SM, Newman, A, Travison, T, Kiel, DP, Santanasto, AJ, Ensrud, KE, Xue, QL, Shardell, M, Duchowny, K, Erlandson, KM, Pencina, KM, Fielding, RA, Magaziner, J, Kwok, T, Karlsson, M, Ohlsson, C, Mellström, D, Hirani, V, Ribom, E, Correa-de-Araujo, R & Bhasin, S 2020, 'Putative Cut-Points in Sarcopenia Components and Incident Adverse Health Outcomes: An SDOC Analysis', Journal of the American Geriatrics Society, vol. 68, no. 7, pp. 1429-1437. https://doi.org/10.1111/jgs.16517

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title = "Putative Cut-Points in Sarcopenia Components and Incident Adverse Health Outcomes: An SDOC Analysis",

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.",

keywords = "gait speed, grip strength, hip fracture, mobility limitation, sarcopenia",

author = "Cawthon, {Peggy M.} and Todd Manini and Patel, {Sheena M.} and Anne Newman and Thomas Travison and Kiel, {Douglas P.} and Santanasto, {Adam J.} and Ensrud, {Kristine E.} and Xue, {Qian Li} and Michelle Shardell and Kate Duchowny and Erlandson, {Kristine M.} and Pencina, {Karol M.} and Fielding, {Roger A.} and Jay Magaziner and Timothy Kwok and Magnus Karlsson and Claes Ohlsson and Dan Mellstr{\"o}m and Vasant Hirani and Eva Ribom and Rosaly Correa-de-Araujo and Shalender Bhasin",

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year = "2020",

month = jul,

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doi = "10.1111/jgs.16517",

language = "English (US)",

volume = "68",

pages = "1429--1437",

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TY - JOUR

T1 - Putative Cut-Points in Sarcopenia Components and Incident Adverse Health Outcomes

T2 - An SDOC Analysis

AU - Cawthon, Peggy M.

AU - Manini, Todd

AU - Patel, Sheena M.

AU - Newman, Anne

AU - Travison, Thomas

AU - Kiel, Douglas P.

AU - Santanasto, Adam J.

AU - Ensrud, Kristine E.

AU - Xue, Qian Li

AU - Shardell, Michelle

AU - Duchowny, Kate

AU - Erlandson, Kristine M.

AU - Pencina, Karol M.

AU - Fielding, Roger A.

AU - Magaziner, Jay

AU - Kwok, Timothy

AU - Karlsson, Magnus

AU - Ohlsson, Claes

AU - Mellström, Dan

AU - Hirani, Vasant

AU - Ribom, Eva

AU - Correa-de-Araujo, Rosaly

AU - Bhasin, Shalender

PY - 2020/7/1

Y1 - 2020/7/1

N2 - 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.

AB - 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.

KW - gait speed

KW - grip strength

KW - hip fracture

KW - mobility limitation

KW - sarcopenia

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Putative Cut-Points in Sarcopenia Components and Incident Adverse Health Outcomes: An SDOC Analysis

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