Alternative Definitions of Sarcopenia, Lower Extremity Performance, and Functional Impairment with Aging in Older Men and Women

OBJECTIVES: To compare two methods for classifying an individual as sarcopenic for predicting decline in physical function in the Health, Aging and Body Composition Study. DESIGN: Observational cohort study with 5 years of follow‐up. SETTING: Communities in Memphis, Tennessee, and Pittsburgh, Pennsy...

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Bibliographic Details
Published in:Journal of the American Geriatrics Society (JAGS) 2007-05, Vol.55 (5), p.769-774
Main Authors: Delmonico, Matthew J., Harris, Tamara B., Lee, Jung-Sun, Visser, Marjolein, Nevitt, Michael, Kritchevsky, Stephen B., Tylavsky, Frances A., Newman, Anne B.
Format: Article
Language:English
Subjects:
Activities of Daily Living
Aged
Aging - physiology
Biological and medical sciences
Body Height
Body Mass Index
elderly
Female
Gait
General aspects
Humans
lean mass
Lower Extremity - physiopathology
Male
Medical sciences
methods
Miscellaneous
Mobility Limitation
Muscular Atrophy - pathology
physical function
Postural Balance
Public health. Hygiene
Public health. Hygiene-occupational medicine
sarcopenia
Thinness
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Summary:OBJECTIVES: To compare two methods for classifying an individual as sarcopenic for predicting decline in physical function in the Health, Aging and Body Composition Study. DESIGN: Observational cohort study with 5 years of follow‐up. SETTING: Communities in Memphis, Tennessee, and Pittsburgh, Pennsylvania. PARTICIPANTS: Men and women aged 70 to 79 (N=2,976, 52% women, 41% black). MEASUREMENTS: Appendicular lean mass (aLM) was measured using dual energy x‐ray absorptiometry, and participants were classified as sarcopenic first using aLM divided by height squared and then using aLM adjusted for height and body fat mass (residuals). Incidence of persistent lower extremity limitation (PLL) was measured according to self‐report, and change in objective lower extremity performance (LEP) measures were observed using the Short Physical Performance Battery. RESULTS: There was a greater risk of incident PLL in women who were sarcopenic using the residuals sarcopenia method than in women who were not sarcopenic (hazard ratio (HR)=1.34, 95% confidence interval (CI)=1.11–1.61) but not in men. Those defined as sarcopenic using the aLM/ht2 method had lower incident PLL than nonsarcopenic men (HR=0.76, 95% CI=0.60–0.96) and women (HR=0.75, 95% CI=0.60–0.93), but these were no longer significant with adjustment for body fat mass. Using the residuals method, there were significantly poorer LEP scores in sarcopenic men and women at baseline and Year 6 and greater 5‐year decline, whereas sarcopenic men defined using the aLM/ht2 method had lower 5‐year decline. Additional adjustment for fat mass attenuated this protective effect. CONCLUSION: These findings suggest that sarcopenia defined using the residuals method, a method that considers height and fat mass together, is better for predicting disability in an individual than the aLM/ht2 method, because it considers fat as part of the definition.
ISSN:0002-8614
1532-5415
DOI:10.1111/j.1532-5415.2007.01140.x