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.
Bibliographical noteFunding Information:
The Sarcopenia Definitions and Outcomes Consortium (SDOC) is supported by the National Institute on Aging (NIA; grant number AG51421), the Foundation for the National Institutes of Health (FNIH; grant numbers CAWT16SARC2 and BHAS16SARC2), and the California Pacific Medical Center Foundation. This research was supported in part by the intramural research program at the NIA. Conflict of interest statements and funding information for the participating cohort studies can be found in Supplemental Material. Drafted the initial manuscript, collected primary data, and obtained funding: Cawthon. Completed statistical analyses: Patel. Obtained funding and provided critical review of the initial manuscript: Bhasin. Provided critical feedback on the manuscript: All other authors. The sponsors of this work had no role in the analysis or interpretation of results and no role in the decision to publish these data.
© 2020 The American Geriatrics Society
Copyright 2020 Elsevier B.V., All rights reserved.
- gait speed
- grip strength
- hip fracture
- mobility limitation
PubMed: MeSH publication types
- Journal Article
- Observational Study
- Research Support, N.I.H., Extramural
- Research Support, Non-U.S. Gov't