Background
Methods
Study population
Exposure variables
Operational definition (men) | EWGSOP Sarcopenia | EWGSOP2 | FNIH Weakness with low muscle mass | |
---|---|---|---|---|
Probable sarcopenia | Sarcopenia | |||
Muscle mass | ALM/ht2 < 7.26 kg/m2 | ALM/ht2 < 7.0kg/m2 | ALMBMI < 0.789 | |
Muscle performance (strength and function) | HGS < 30 kg and/or GS < 0.8 m/s | HGS < 27 kg and/or CS > 15 s | HGS < 27 kg and/or CS > 15 s | HGS < 26 kg |
Outcome measurements
Statistical analysis
Results
All | EWGSOP | EWGSOP2 | FNIH | ||||||
---|---|---|---|---|---|---|---|---|---|
No sarcopenia n = 227 (79%) | Sarcopenia n = 60 (21%) | Not probable sarcopenia n = 78 (27%) | Probable sarcopenia n = 209 (73%) | No sarcopenia N = 229 (80%) | Sarcopenia N = 58 (20%) | No sarcopenia N = 261 (92%) | Sarcopenia N = 24 (8%) | ||
Age, years, mean (SD) | 86.6 (1.0) | 86.6 (1.0) | 86.6 (1.0) | 86.3 (0.9) | 86.7 (1.1)*** | 86.6 (1.1) | 86.5 (1.0) | 86.6 (1.0) | 86.6 (1.1) |
Education, n (%) | |||||||||
6–7 years | 140 (49) | 113 (50) | 27 (45) | 33 (42) | 107 (51) | 112 (49) | 28 (48) | 123 (47) | 16 (67) |
8–13 years | 88 (31) | 65 (29) | 23 (38) | 27 (35) | 61 (29) | 67 (29) | 21 (36) | 81 (31) | 7 (29) |
> 13 years | 59 (20) | 49 (21) | 10 (17) | 18 (23) | 41 (20) | 50 (22) | 9 (16) | 57 (22) | 1 (4) |
MMSE score, median (IQR) | 28 (3) | 28 (3) | 28 (3) | 28 (2) | 28 (3) | 28 (3) | 28 (3) | 28 (2) | 26.5 (4.5) |
Charlson score, median (IQR) | 1 (2) | 1 (2) | 1 (2) | 1 (1) | 1 (2)* | 1 (2) | 1 (2) | 1 (2) | 1.5 (2)** |
Myocardial infarction, n (%) | 57 (20) | 41 (18) | 16 (27) | 17 (22) | 40 (19) | 44 (19) | 13 (22) | 47 (18) | 10 (42)* |
Heart failure, n (%) | 38 (13) | 30 (13) | 8 (13) | 7 (9) | 31 (15) | 34 (15) | 4 (7) | 32 (12) | 6 (25) |
Peripheral vascular disease, n (%) | 11 (4) | 9 (4) | 2 (3) | 4 (5) | 7 (3) | 10 (4) | 1 (2) | 9 (3) | 2 (8) |
Cerebrovascular disease, n (%) | 41 (14) | 32 (14) | 9 (15) | 9 (12) | 32 (15) | 30 (13) | 11 (19) | 38 (15) | 3 (13) |
Dementia, n (%) | 4 (1) | 4 (2) | 0 (0) | 2 (3) | 2 (1) | 4 (2) | 0 (0) | 4 (2) | 0 (0) |
Chronic pulmonary disease, n (%) | 17 (6) | 13 (6) | 4 (7) | 3 (4) | 14 (7) | 12 (5) | 5 (9) | 14 (5) | 2 (8) |
Rheumatic disease, n (%) | 12 (4) | 9 (4) | 3 (5) | 0 (0) | 12 (6)* | 9 (4) | 3 (5) | 8 (3) | 3 (13) |
Diabetes, n (%) | 27 (9) | 17 (7) | 10 (17)* | 5 (6) | 22 (11) | 21 (9) | 6 (10) | 19 (7) | 8 (33)** |
Renal disease, n (%) | 8 (3) | 6 (3) | 2 (3) | 2 (3) | 6 (3) | 5 (2) | 3 (5) | 7 (3) | 1 (4) |
History of cancer, n (%) | 56 (20) | 48 (21) | 8 (13) | 8 (10) | 48 (23)* | 46 (20) | 10 (17) | 50 (19) | 6 (25) |
Smoking | |||||||||
yes, n (%) | 16 (6) | 12 (5) | 4 (7) | 4 (5) | 12 (6) | 14 (6) | 2 (3) | 14 (5) | 2 (8) |
no, n (%) | 271 (94) | 215 (95) | 56 (93) | 74 (95) | 197 (94) | 215 (94) | 56 (97) | 247 (95) | 22 (92) |
All | EWGSOP | EWGSOP2 | FNIH | ||||||
---|---|---|---|---|---|---|---|---|---|
No sarcopenia n = 227 (79%) | Sarcopenia n = 60 (21%) | Not probable sarcopenia n = 78 (27%) | Probable sarcopenia n = 209 (73%) | No sarcopenia n = 229 (80%) | Sarcopenia n = 58 (20%) | No sarcopenia n = 261 (92%) | Sarcopenia n = 24 (8%) | ||
Height, cm, mean (SD) | 172.4 (6.0) | 173.0 (5.9) | 170.1 (6.0)*** | 172.1 (5.9) | 172.5 (6.0) | 172.6 (5.9) | 171.6 (6.4) | 172.9 (5.8) | 166.8 (4.7)*** |
Weight, kg, mean (SD) | 76.2 (11.2) | 78.4 (10.7) | 67.8 (9.0)*** | 75.1 (10.3) | 76.6 (11.5) | 78.1 (10.9) | 68.7 (9.1)*** | 76.1 (11.2) | 79.2 (11.1) |
BMI, kg/m2, mean (SD) | 25.6 (3.4) | 26.2 (3.3) | 23.4 (2.5)*** | 25.3 (3.1) | 25.7 (3.5) | 26.2 (3.3) | 23.3 (2.7)*** | 25.4 (3.3) | 28.4 (3.2)*** |
Waist circumference, | |||||||||
- cm, mean (SD | 100 (10) | 101 (9) | 95 (9)*** | 98 (9) | 100 (10)* | 101 (9) | 95 (9)*** | 99 (10) | 106 (8)*** |
> 102 cm, n (%) | 107 (37) | 96 (42) | 11 (18)*** | 23 (29) | 84 (40) | 96 (42) | 11 (19)** | 91 (35) | 16 (67)** |
SMI, kg/m2, mean (SD) | 7.46 (0.77) | 7.67 (0.71) | 6.66 (0.41)*** | 7.55 (0.71) | 7.42 (0.80) | 7.71 (0.62) | 6.46 (0.45)*** | 7.49 (0.77) | 7.24 (0.71) |
< 7.0 kg/m2, n (%) | 72 (25) | 31 (14) | 41 (68)*** | 14 (18) | 58 (28) | 14 (6) | 58 (100)*** | 63 (24) | 7 (29) |
< 7.26 kg/m2, n (%) | 109 (38) | 49 (22) | 60 (100)*** | 26 (33) | 83 (40) | 51 (22) | 58 (100)*** | 96 (37) | 11 (46) |
ASMM, kg, mean (SD) | 22.2 (2.8) | 22.9 (2.6) | 19.3 (1.7)*** | 22.4 (2.7) | 22.1 (2.9) | 23.0 (2.5) | 19.0 (1.9)*** | 22.4 (2.8) | 20.1 (2.2)*** |
ALMBMI, mean (SD) | 0.874 (0.117) | 0.885 (0.119) | 0.832 (0.098)** | 0.891 (0.116) | 0.867 (0.117) | 0.886 (0.113) | 0.826 (0.120)*** | 0.889 (0.109) | 0.710 (0.038)*** |
< 0.789, n (%) | 62 (22) | 43 (19) | 19 (32) | 12 (15) | 50 (24) | 42 (18) | 20 (34)* | 37 (14) | 24 (100)*** |
FMtot, kg, mean (SD) | 22.2 (7.5) | 23.0 (7.5) | 19.5 (7.0)** | 20.7 (7.1) | 22.8 (7.6)* | 22.9 (7.6) | 19.7 (6.7)** | 21.7 (7.4) | 28.6 (6.3)*** |
FMI, kg/m2, mean (SD) | 7.48 (2.50) | 7.69 (2.49) | 6.71 (2.38)** | 7.0 (2.32) | 7.66 (2.54)* | 7.69 (2.52) | 6.68 (2.25)** | 7.24 (2.39) | 10.24 (2.02)*** |
GS, m/s, mean (SD) | 1.36 (0.31) | 1.40 (0.31) | 1.23 (0.30)*** | 1.56 (0.27) | 1.28 (0.29)*** | 1.39 (0.31) | 1.24 (0.29)*** | 1.39 (0.30) | 1.05 (0.28)*** |
< 0.8 m/s, n (%) | 13 (5) | 6 (3) | 7 (12)** | 0 (0) | 13 (6)* | 9 (4) | 4 (7) | 8 (3) | 5 (22)** |
HGS, kg, mean (SD) | 30.2 (6.5) | 31.6 (6.3) | 24.9 (3.8)*** | 33.8 (5.2) | 28.9 (6.4)*** | 30.8 (6.6) | 27.7 (5.4)*** | 31.1 (5.9) | 20.7 (3.7)*** |
< 30 kg, n (%) | 132 (46) | 72 (32) | 60 (100)*** | 15 (19) | 117 (56)*** | 95 (42) | 37 (65)** | 108 (41) | 24 (100)*** |
< 27 kg, n (%) | 79 (28) | 47 (21) | 32 (53)*** | 0 (0) | 79 (38)*** | 57 (25) | 22 (39)* | 55 (21) | 24 (100)*** |
< 26 kg, n (%) | 60 (21) | 35 (16) | 25 (42)*** | 0 (0) | 60 (29)*** | 42 (18) | 18 (32)* | 36 (14) | 24 (100)*** |
CSa, mean, sec (SD) | 17.9 (7.1) | 17.6 (6.4) | 19.4 (9.4) | 13.1 (1.5) | 20.2 (7.5)*** | 17.7 (7.1) | 19.3 (7.2) | 17.8 (7.2) | 20.4 (5.7) |
> 15 s, n (%) | 189 (66) | 144 (64) | 45 (75) | 0 (0) | 189 (91)*** | 137 (60) | 52 (90)*** | 167 (64) | 21 (91)* |
Prevalence of sarcopenia
Mortality in relation to sarcopenia and its components
Model 1 HR (95% CI) | p | Model 2 HR (95% CI) | p | Model 3 HR (95% CI) | p | |
---|---|---|---|---|---|---|
Sarcopenia (EWGSOP) | 1.97 (1.14–3.39) | 0.015 | 1.90 (1.10–3.28) | 0.021 | 1.95 (1.12–3.40) | 0.019 |
Probable sarcopenia (EWGSOP2) | 3.82 (1.64–8.87) | 0.002 | 3.17 (1.34–7.49) | 0.008 | 3.26 (1.38–7.70) | 0.007 |
Sarcopenia (EWGSOP2) | 1.50 (0.84–2.65) | 0.17 | 1.55 (0.87–2.75) | 0.14 | 1.70 (0.94–3.05) | 0.078 |
Sarcopenia (FNIH) | 1.96 (0.93–4.13) | 0.077 | 1.62 (0.75–3.50) | 0.22 | 1.65 (0.73–3.72) | 0.23 |
Muscle mass measurements and body composition | ||||||
SMIb, kg/m2 | 0.69 (0.54–0.90) | 0.005 | 0.68 (0.52–0.87) | 0.003 | 0.64 (0.50–0.82) | < 0.001 |
< 7.0 kg/m2 | 1.29 (0.74–2.24) | 0.37 | 1.42 (0.81–2.49) | 0.22 | 1.57 (0.89–2.78) | 0.12 |
< 7.26 kg/m2 | 1.73 (1.04–2.88) | 0.033 | 1.77 (1.07–2.94) | 0.026 | 1.94 (1.15–3.28) | 0.013 |
ASMMb, kg | 0.68 (0.53–0.89) | 0.004 | 0.67 (0.51–0.87) | 0.003 | 0.65 (0.50–0.83) | 0.001 |
< 19.75 kg | 2.24 (1.30–3.85) | 0.004 | 2.31 (1.34–3.99) | 0.003 | 2.56 (1.46–4.47) | 0.001 |
< 20 kg | 1.96 (1.15–3.36) | 0.014 | 2.06 (1.20–3.54) | 0.009 | 2.01 (1.17–3.46) | 0.012 |
ALMbBMI | 0.94 (0.72–1.22) | 0.64 | 0.98 (0.76–1.27) | 0.88 | 1.05 (0.81–1.37) | 0.69 |
< 0.789 | 1.38 (0.78–2.44) | 0.27 | 1.26 (0.71–2.25) | 0.43 | 1.05 (0.57–1.96) | 0.87 |
BMIb, kg/m2 | 0.75 (0.57–0.99) | 0.039 | 0.73 (0.56–0.95) | 0.017 | 0.65 (0.50–0.84) | 0.001 |
FMbtot, kg | 0.90 (0.70–1.17) | 0.44 | 0.86 (0.67–1.10) | 0.23 | 0.79 (0.62–1.01) | 0.056 |
FMIb, kg/m2 | 0.94 (0.73–1.21) | 0.63 | 0.88 (0.69–1.14) | 0.34 | 0.80 (0.63–1.02) | 0.077 |
Muscle strength and physical performance | ||||||
HGSb, kg | 0.61 (0.47–0.80) | < 0.001 | 0.65 (0.49–0.85) | 0.001 | 0.62 (0.47–0.82) | < 0.001 |
< 30 kg | 1.97 (1.17–3.33) | 0.011 | 1.83 (1.08–3.11) | 0.025 | 1.87 (1.10–3.18) | 0.021 |
< 27 kg | 1.64 (0.97–2.78) | 0.066 | 1.52 (0.89–2.59) | 0.12 | 1.56 (0.91–2.69) | 0.11 |
< 26 kg | 1.78 (1.03–3.11) | 0.040 | 1.60 (0.91–2.82) | 0.10 | 1.76 (0.97–3.20) | 0.062 |
GSb, m/s | 0.58 (0.45–0.74) | < 0.001 | 0.62 (0.48–0.81) | < 0.001 | 0.61 (0.46–0.81) | 0.001 |
≤0.8 m/s | 2.67 (1.21–5.88) | 0.015 | 2.13 (0.95–4.76) | 0.065 | 2.24 (0.94–5.31) | 0.067 |
< 0.8 m/s | 2.24 (0.89–5.60) | 0.085 | 1.66 (0.65–4.23) | 0.29 | 1.69 (0.62–4.59) | 0.30 |
CSa, b, sec | 1.26 (1.04–1.53) | 0.020 | 1.13 (0.89–1.43) | 0.33 | 1.14 (0.88–1.47) | 0.31 |
> 15 s | 2.77 (1.41–5.48) | 0.003 | 2.28 (1.13–4.61) | 0.022 | 2.44 (1.20–4.94) | 0.013 |
Hospitalisation in relation to sarcopenia and its components
Model 1 RR (95% CI) | p–value | Model 2 RR (95% CI) | p–value | Model 3 RR (95% CI) | p–value | |
---|---|---|---|---|---|---|
Number of hospitalisations | ||||||
Sarcopenia (EWGSOP) | 1.49 (1.00–2.22) | 0.048 | 1.33 (0.95–1.87) | 0.095 | 1.31 (0.93–1.83) | 0.12 |
Probable sarcopenia (EWGSOP2) | 1.46 (1.05–2.03) | 0.024 | 1.25 (0.91–1.72) | 0.17 | 1.25 (0.91–1.72) | 0.17 |
Sarcopenia (EWGSOP2) | 1.18 (0.80–1.75) | 0.41 | 1.11 (0.79–1.55) | 0.54 | 1.10 (0.79–1.53) | 0.57 |
Sarcopenia (FNIH) | 2.10 (1.33–3.33) | 0.002 | 1.78 (1.07–2.97) | 0.026 | 1.75 (1.10–2.81) | 0.019 |
Days of hospitalisation | ||||||
Sarcopenia (EWGSOP) | 1.63 (0.92–2.90) | 0.097 | 1.38 (0.83–2.32) | 0.22 | 1.36 (0.81–2.29) | 0.24 |
Probable sarcopenia (EWGSOP2) | 2.90 (1.86–4.52) | < 0.001 | 2.20 (1.42–3.40) | < 0.001 | 2.12 (1.36–3.30) | 0.001 |
Sarcopenia (EWGSOP2) | 1.03 (0.60–1.76) | 0.91 | 1.00 (0.61–1.62) | 0.99 | 1.00 (0.62–1.63) | 0.99 |
Sarcopenia (FNIH) | 2.59 (1.34–5.03) | 0.005 | 1.89 (0.97–3.67) | 0.062 | 1.80 (0.93–3.47) | 0.079 |