Cutpoints for Muscle Mass and Strength Derived from Weakness or Mobility Impairment and Compared with Other Diagnostic Criteria in Community-Dwelling Elderly People

Overview

Journal Calcif Tissue Int

Specialty Pathology

Date 2020 Nov 28

PMID 33247326

Authors

Hong-Qi Xu

Jia-Qi Sun

Yu Liu

Liao Tian

Jing-Min Liu

Ji-Peng Shi

Min Liu

Xiu-Yuan Zheng

Affiliations

Soon will be listed here.

Abstract

We identified the strength cutpoints concerning mobility impairment, then identified the muscle mass cutpoints concerning weakness, and compared the results with other diagnostic criteria to develop the clinical diagnostic criteria associated with functional impairment. In 7583 elderly people, classification and regression tree (CART) and receiver operating characteristic curve (ROC) analyses were used for determining cutpoints for handgrip strength (HGS) and appendicular lean mass (ALM) indices associated with slowness or weakness. Logistic regressions were then used to quantify the strength of the association between muscle mass (or strength) categories and weakness (or slowness). The CART second cutpoints of muscle mass and strength indices were lower than those specified by the ROC method and were between those cutpoints determined by the 20th and Mean-2SD methods. After adjusting for covariates, the associations remained significant in handgrip strength categories defined by the CART and ROC cutpoints and HGS/BMI categories defined by the CART, ROC, and 20th cutpoints in men and women (P < 0.05), ALM, ALM/Ht categories defined by all four cutpoints (P < 0.05) and ALM/BMI categories defined by CART and ROC cutpoints in men (P < 0.05), and ALM and ALM/Ht categories defined by the CART cutpoints in women (P < 0.05). Our approaches resulted in a definition of weak strength as handgrip strength or HGS/BMI less than 26.55 kg or 1.114 in men and less than 16.45 kg or 0.697 in women and then defined ALM, ALM/Ht, or ALM/BMI less than 18.92 kg, 7.08 kg/m, or 0.795 in men and less than 15.04 kg, 5.99 kg/m, or 0.517 in women as low lean mass.

References

Chen L, Liu L, Woo J, Assantachai P, Auyeung T, Bahyah K . Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc. 2014; 15(2):95-101. DOI: 10.1016/j.jamda.2013.11.025. View

Fielding R, Vellas B, Evans W, Bhasin S, Morley J, Newman A . Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011; 12(4):249-56. PMC: 3377163. DOI: 10.1016/j.jamda.2011.01.003. View

McLean R, Kiel D . Developing consensus criteria for sarcopenia: an update. J Bone Miner Res. 2015; 30(4):588-92. DOI: 10.1002/jbmr.2492. View

Kim H, Hirano H, Edahiro A, Ohara Y, Watanabe Y, Kojima N . Sarcopenia: Prevalence and associated factors based on different suggested definitions in community-dwelling older adults. Geriatr Gerontol Int. 2016; 16 Suppl 1:110-22. DOI: 10.1111/ggi.12723. View

Zeng P, Wu S, Han Y, Liu J, Zhang Y, Zhang E . Differences in body composition and physical functions associated with sarcopenia in Chinese elderly: reference values and prevalence. Arch Gerontol Geriatr. 2014; 60(1):118-23. DOI: 10.1016/j.archger.2014.08.010. View

Bai H, Sun J, Chen M, Xu D, Xie H, Yu Z . Age-related decline in skeletal muscle mass and function among elderly men and women in Shanghai, China: a cross sectional study. Asia Pac J Clin Nutr. 2016; 25(2):326-32. DOI: 10.6133/apjcn.2016.25.2.14. View

Kim Y, Kim K, Paik N, Kim K, Jang H, Lim J . Muscle strength: A better index of low physical performance than muscle mass in older adults. Geriatr Gerontol Int. 2015; 16(5):577-85. DOI: 10.1111/ggi.12514. View

Trombetti A, Reid K, Hars M, Herrmann F, Pasha E, Phillips E . Age-associated declines in muscle mass, strength, power, and physical performance: impact on fear of falling and quality of life. Osteoporos Int. 2015; 27(2):463-71. PMC: 4960453. DOI: 10.1007/s00198-015-3236-5. View

Xu H, Shi J, Shen C, Liu Y, Liu J, Zheng X . Sarcopenia-related features and factors associated with low muscle mass, weak muscle strength, and reduced function in Chinese rural residents: a cross-sectional study. Arch Osteoporos. 2018; 14(1):2. DOI: 10.1007/s11657-018-0545-2. View

10.

Zeng P, Han Y, Pang J, Wu S, Gong H, Zhu J . Sarcopenia-related features and factors associated with lower muscle strength and physical performance in older Chinese: a cross sectional study. BMC Geriatr. 2016; 16:45. PMC: 4754915. DOI: 10.1186/s12877-016-0220-7. View

11.

Xue C, Liu Y, Wang J, Zhang R, Zhang J, Zhang Y . Consumption of medium- and long-chain triacylglycerols decreases body fat and blood triglyceride in Chinese hypertriglyceridemic subjects. Eur J Clin Nutr. 2009; 63(7):879-86. DOI: 10.1038/ejcn.2008.76. View

12.

Glenn J, Gray M, Binns A . Relationship of Sit-to-Stand Lower-Body Power With Functional Fitness Measures Among Older Adults With and Without Sarcopenia. J Geriatr Phys Ther. 2015; 40(1):42-50. DOI: 10.1519/JPT.0000000000000072. View

13.

Smith W, Del Rossi G, Adams J, Abderlarahman K, Asfour S, Roos B . Simple equations to predict concentric lower-body muscle power in older adults using the 30-second chair-rise test: a pilot study. Clin Interv Aging. 2010; 5:173-80. PMC: 2920197. DOI: 10.2147/cia.s7978. View

14.

Kim K, Jang H, Lim S . Differences among skeletal muscle mass indices derived from height-, weight-, and body mass index-adjusted models in assessing sarcopenia. Korean J Intern Med. 2016; 31(4):643-50. PMC: 4939509. DOI: 10.3904/kjim.2016.015. View

15.

Chin K, Soelaiman I, Naina Mohamed I, Mohamed N, Shuid A, Muhammad N . Discrepancy between the quantitative ultrasound value of Malaysian men and the manufacturer's reference and the impact on classification of bone health status. J Clin Densitom. 2012; 16(2):189-95. DOI: 10.1016/j.jocd.2012.03.004. View

16.

Wong A, Liu H, Tsai M, Schwartz E, Yeh C, Wang H . Arterial spin-labeling magnetic resonance imaging of brain maturation in early childhood: Mathematical model fitting to assess age-dependent change of cerebral blood flow. Magn Reson Imaging. 2019; 59:114-120. DOI: 10.1016/j.mri.2019.03.016. View

17.

Li Y, Zou Z, Luo J, Ma J, Ma Y, Jing J . The predictive value of anthropometric indices for cardiometabolic risk factors in Chinese children and adolescents: A national multicenter school-based study. PLoS One. 2020; 15(1):e0227954. PMC: 6974264. DOI: 10.1371/journal.pone.0227954. View

18.

Kim Y, Han B, Han K, Shin K, Lee H, Kim T . Optimal cutoffs for low skeletal muscle mass related to cardiovascular risk in adults: The Korea National Health and Nutrition Examination Survey 2009-2010. Endocrine. 2015; 50(2):424-33. DOI: 10.1007/s12020-015-0577-y. View

19.

Menant J, Weber F, Lo J, Sturnieks D, Close J, Sachdev P . Strength measures are better than muscle mass measures in predicting health-related outcomes in older people: time to abandon the term sarcopenia?. Osteoporos Int. 2016; 28(1):59-70. DOI: 10.1007/s00198-016-3691-7. View

20.

Edwards M, Buehring B . Novel Approaches to the Diagnosis of Sarcopenia. J Clin Densitom. 2015; 18(4):472-7. DOI: 10.1016/j.jocd.2015.04.010. View