Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women

Matthew J. Delmonico, Tamara B. Harris, Jung Sun Lee, Marjolein Visser, Michael Nevitt, Stephen B. Kritchevsky, Frances Tylavsky, Anne B. Newman

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)769-774
Number of pages6
JournalJournal of the American Geriatrics Society
Volume55
Issue number5
DOIs
StatePublished - May 1 2007

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Sarcopenia
Lower Extremity
Fats
Confidence Intervals
Adipose Tissue
Body Composition
Self Report
Observational Studies
Cohort Studies
X-Rays
Incidence
Health

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology

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Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women. / Delmonico, Matthew J.; Harris, Tamara B.; Lee, Jung Sun; Visser, Marjolein; Nevitt, Michael; Kritchevsky, Stephen B.; Tylavsky, Frances; Newman, Anne B.

In: Journal of the American Geriatrics Society, Vol. 55, No. 5, 01.05.2007, p. 769-774.

Research output: Contribution to journalArticle

Delmonico, Matthew J. ; Harris, Tamara B. ; Lee, Jung Sun ; Visser, Marjolein ; Nevitt, Michael ; Kritchevsky, Stephen B. ; Tylavsky, Frances ; Newman, Anne B. / Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women. In: Journal of the American Geriatrics Society. 2007 ; Vol. 55, No. 5. pp. 769-774.
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abstract = "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.",
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T1 - Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women

AU - Delmonico, Matthew J.

AU - Harris, Tamara B.

AU - Lee, Jung Sun

AU - Visser, Marjolein

AU - Nevitt, Michael

AU - Kritchevsky, Stephen B.

AU - Tylavsky, Frances

AU - Newman, Anne B.

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N2 - 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.

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