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Recent sarcopenia definitions - prevalence, agreement and mortality associations among men: findings from population-based cohorts

Recent sarcopenia definitions - prevalence, agreement and mortality associations among men: findings from population-based cohorts
Recent sarcopenia definitions - prevalence, agreement and mortality associations among men: findings from population-based cohorts

Background: The 2019 European Working Group on Sarcopenia in Older People (EWGSOP2) and the Sarcopenia Definitions and Outcomes Consortium (SDOC) have recently proposed sarcopenia definitions. However, comparisons of the performance of these approaches in terms of thresholds employed, concordance in individuals and prediction of important health-related outcomes such as death are limited. We addressed this in a large multinational assembly of cohort studies that included information on lean mass, muscle strength, physical performance and health outcomes. Methods: White men from the Health Aging and Body Composition (Health ABC) Study, Osteoporotic Fractures in Men (MrOS) Study cohorts (Sweden, USA), the Hertfordshire Cohort Study (HCS) and the Sarcopenia and Physical impairment with advancing Age (SarcoPhAge) Study were analysed. Appendicular lean mass (ALM) was ascertained using DXA; muscle strength by grip dynamometry; and usual gait speed over courses of 2.4–6 m. Deaths were recorded and verified. Definitions of sarcopenia were as follows: EWGSOP2 (grip strength <27 kg and ALM index <7.0 kg/m 2), SDOC (grip strength <35.5 kg and gait speed <0.8 m/s) and Modified SDOC (grip strength <35.5 kg and gait speed <1.0 m/s). Cohen's kappa statistic was used to assess agreement between original definitions (EWGSOP2 and SDOC). Presence versus absence of sarcopenia according to each definition in relation to mortality risk was examined using Cox regression with adjustment for age and weight; estimates were combined across cohorts using random-effects meta-analysis. Results: Mean (SD) age of participants (n = 9170) was 74.3 (4.9) years; 5929 participants died during a mean (SD) follow-up of 12.1 (5.5) years. The proportion with sarcopenia according to each definition was EWGSOP2 (1.1%), SDOC (1.7%) and Modified SDOC (5.3%). Agreement was weak between EWGSOP2 and SDOC (κ = 0.17). Pooled hazard ratios (95% CI) for mortality for presence versus absence of each definition were EWGSOP2 [1.76 (1.42, 2.18), I 2: 0.0%]; SDOC [2.75 (2.28, 3.31), I 2: 0.0%]; and Modified SDOC [1.93 (1.54, 2.41), I 2: 58.3%]. Conclusions: There was low prevalence and poor agreement among recent sarcopenia definitions in community-dwelling cohorts of older white men. All indices of sarcopenia were associated with mortality. The strong relationship between sarcopenia and mortality, regardless of the definition, illustrates that identification of appropriate management and lifecourse intervention strategies for this condition is of paramount importance.

Ageing, Epidemiology, Mortality, Prevalence, Sarcopenia
2190-5991
565-575
Westbury, Leo
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Beaudart, Charlotte
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Bruyère, Olivier
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Cauley, Jane A.
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Cawthon, Peggy M.
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Cruz-Jentoft, Alfonso Jose
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Curtis, Elizabeth
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Ensrud, Kristine
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Fielding, Roger A.
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Johansson, Helena
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Kanis, John A.
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Karlsson, Magnus K.
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Lane, Nancy E.
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Lengelé, Laetitia
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Lorentzon, Mattias
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McCloskey, Eugene
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Mellström, Dan
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Newman, Anne B.
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Ohlsson, Claes
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Orwoll, Eric
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Reginster, Jean Yves
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Ribom, Eva
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Rosengren, Bjorn E.
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Schousboe, John T.
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Shiroma, Eric J.
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Harvey, Nicholas
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Dennison, Elaine
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Cooper, Cyrus
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Westbury, Leo
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Beaudart, Charlotte
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Bruyère, Olivier
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Cauley, Jane A.
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Cawthon, Peggy M.
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Cruz-Jentoft, Alfonso Jose
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Curtis, Elizabeth
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Ensrud, Kristine
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Fielding, Roger A.
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Johansson, Helena
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Kanis, John A.
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Karlsson, Magnus K.
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Lane, Nancy E.
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Lengelé, Laetitia
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Lorentzon, Mattias
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McCloskey, Eugene
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Mellström, Dan
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Newman, Anne B.
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Ohlsson, Claes
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Orwoll, Eric
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Reginster, Jean Yves
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Ribom, Eva
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Rosengren, Bjorn E.
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Schousboe, John T.
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Shiroma, Eric J.
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Harvey, Nicholas
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Dennison, Elaine
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Cooper, Cyrus
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Westbury, Leo, Beaudart, Charlotte, Bruyère, Olivier, Cauley, Jane A., Cawthon, Peggy M., Cruz-Jentoft, Alfonso Jose, Curtis, Elizabeth, Ensrud, Kristine, Fielding, Roger A., Johansson, Helena, Kanis, John A., Karlsson, Magnus K., Lane, Nancy E., Lengelé, Laetitia, Lorentzon, Mattias, McCloskey, Eugene, Mellström, Dan, Newman, Anne B., Ohlsson, Claes, Orwoll, Eric, Reginster, Jean Yves, Ribom, Eva, Rosengren, Bjorn E., Schousboe, John T., Shiroma, Eric J., Harvey, Nicholas, Dennison, Elaine and Cooper, Cyrus (2023) Recent sarcopenia definitions - prevalence, agreement and mortality associations among men: findings from population-based cohorts. Journal of Cachexia, Sarcopenia and Muscle, 14 (1), 565-575. (doi:10.1002/jcsm.13160).

Record type: Article

Abstract

Background: The 2019 European Working Group on Sarcopenia in Older People (EWGSOP2) and the Sarcopenia Definitions and Outcomes Consortium (SDOC) have recently proposed sarcopenia definitions. However, comparisons of the performance of these approaches in terms of thresholds employed, concordance in individuals and prediction of important health-related outcomes such as death are limited. We addressed this in a large multinational assembly of cohort studies that included information on lean mass, muscle strength, physical performance and health outcomes. Methods: White men from the Health Aging and Body Composition (Health ABC) Study, Osteoporotic Fractures in Men (MrOS) Study cohorts (Sweden, USA), the Hertfordshire Cohort Study (HCS) and the Sarcopenia and Physical impairment with advancing Age (SarcoPhAge) Study were analysed. Appendicular lean mass (ALM) was ascertained using DXA; muscle strength by grip dynamometry; and usual gait speed over courses of 2.4–6 m. Deaths were recorded and verified. Definitions of sarcopenia were as follows: EWGSOP2 (grip strength <27 kg and ALM index <7.0 kg/m 2), SDOC (grip strength <35.5 kg and gait speed <0.8 m/s) and Modified SDOC (grip strength <35.5 kg and gait speed <1.0 m/s). Cohen's kappa statistic was used to assess agreement between original definitions (EWGSOP2 and SDOC). Presence versus absence of sarcopenia according to each definition in relation to mortality risk was examined using Cox regression with adjustment for age and weight; estimates were combined across cohorts using random-effects meta-analysis. Results: Mean (SD) age of participants (n = 9170) was 74.3 (4.9) years; 5929 participants died during a mean (SD) follow-up of 12.1 (5.5) years. The proportion with sarcopenia according to each definition was EWGSOP2 (1.1%), SDOC (1.7%) and Modified SDOC (5.3%). Agreement was weak between EWGSOP2 and SDOC (κ = 0.17). Pooled hazard ratios (95% CI) for mortality for presence versus absence of each definition were EWGSOP2 [1.76 (1.42, 2.18), I 2: 0.0%]; SDOC [2.75 (2.28, 3.31), I 2: 0.0%]; and Modified SDOC [1.93 (1.54, 2.41), I 2: 58.3%]. Conclusions: There was low prevalence and poor agreement among recent sarcopenia definitions in community-dwelling cohorts of older white men. All indices of sarcopenia were associated with mortality. The strong relationship between sarcopenia and mortality, regardless of the definition, illustrates that identification of appropriate management and lifecourse intervention strategies for this condition is of paramount importance.

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Accepted/In Press date: 25 November 2022
e-pub ahead of print date: 5 January 2023
Published date: February 2023
Additional Information: Funding Information: The Health, Aging and Body Composition Study was supported by the National Institute on Aging (NIA) grants (R01AG027017, P30AG024827, T32AG021885 and K07AG033174); the Intramural Research Program of the National Institutes of Health (N01AG62101, N01AG62103, N01AG62106 and R01AG028050); and a National Institute of Nursing Research grant (R01NR012459). The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute on Aging (NIA), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS; U01AR066160), the National Center for Advancing Translational Sciences (NCATS; UL1TR000128) and NIH Roadmap for Medical Research under the following grant numbers: U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160 and UL1 TR000128. MrOS Sweden is supported by the Swedish Research Council, ALF/LUA research grants in Gothenburg, ALF, Region Skane (FoUU), Skåne University Hospital Foundation and the King Gustav V and Queen Victoria Frimurarestiftelse Research Foundation. The Hertfordshire Cohort Study was supported by the Medical Research Council University Unit Partnership grant number MRC_MC_UP_A620_1014. Roger Fielding's participation was supported by the U.S. Department of Agriculture (USDA), under agreement no. 58-1950-4-003 any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the view of the USDA. Cyrus Cooper, Elaine Dennison, Nicholas Harvey, Elizabeth Curtis and Leo Westbury are supported by the UK Medical Research Council (MC_PC_21003; MC_PC_21001). The authors of this manuscript certify that they comply with the ethical guidelines for authorship and publishing in the Journal of Cachexia, Sarcopenia and Muscle.33 All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All participants provided informed consent prior to their inclusion in the study. The authors thank the study participants as well as members of the scientific and data collection teams. Funding Information: Cyrus Cooper reports personal fees (outside the submitted work) from Amgen, Danone, Eli Lilly, GSK, Kyowa Kirin, Medtronic, Merck, Nestle, Novartis, Pfizer, Roche, Servier, Shire, Takeda and UCB. Elaine Dennison has received lecture fees and honoraria from UCB, Pfizer, Lilly and Viatris outside of the submitted work. Nicholas Harvey reports consultancy, lecture fees and honoraria (outside the submitted work) from Alliance for Better Bone Health, AMGEN, MSD, Eli Lilly, Servier, Shire, UCB, Kyowa Kirin, Consilient Healthcare, Radius Health and Internis Pharma. Roger Fielding reports grants from the National Institutes of Health (National Institute on Aging) and the USDA, during the conduct of the study; grants, personal fees and other from Axcella Health; other from Inside Tracker; grants and personal fees from Biophytis; grants and personal fees from Astellas; personal fees from Pfizer; personal fees from Reneo; personal fees from Cytokinetics; personal fees from Amazentis; grants and personal fees from Nestle; and personal fees from Glaxo Smith Kline, outside the submitted work. Jean‐Yves Reginster declares grant support from industry through institution (IBSA‐Genevrier, Mylan, CNIEL, Radius Health, TRB), lecture fees when speaking at the invitation of sponsor [IBSA‐Genevrier, Mylan, CNIEL, Dairy Research Council (DRC), Nutricia, Danone, Agnovos] and consulting fees or paid advisory boards (IBSA‐Genevrier, Mylan, Radius Health, Pierre Fabre, Faes Pharma, Rejuvenate Biomed, Samumed, Teva, Theramex, Pfizer, Mithra Pharmaceuticals). The remaining authors declare that they have no conflicts of interest. Funding Information: The Health, Aging and Body Composition Study was supported by the National Institute on Aging (NIA) grants (R01AG027017, P30AG024827, T32AG021885 and K07AG033174); the Intramural Research Program of the National Institutes of Health (N01AG62101, N01AG62103, N01AG62106 and R01AG028050); and a National Institute of Nursing Research grant (R01NR012459). The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute on Aging (NIA), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS; U01AR066160), the National Center for Advancing Translational Sciences (NCATS; UL1TR000128) and NIH Roadmap for Medical Research under the following grant numbers: U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160 and UL1 TR000128. MrOS Sweden is supported by the Swedish Research Council, ALF/LUA research grants in Gothenburg, ALF, Region Skane (FoUU), Skåne University Hospital Foundation and the King Gustav V and Queen Victoria Frimurarestiftelse Research Foundation. The Hertfordshire Cohort Study was supported by the Medical Research Council University Unit Partnership grant number MRC_MC_UP_A620_1014. Roger Fielding's participation was supported by the U.S. Department of Agriculture (USDA), under agreement no. 58‐1950‐4‐003 any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the view of the USDA. Cyrus Cooper, Elaine Dennison, Nicholas Harvey, Elizabeth Curtis and Leo Westbury are supported by the UK Medical Research Council (MC_PC_21003; MC_PC_21001). Publisher Copyright: © 2023 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders.
Keywords: Ageing, Epidemiology, Mortality, Prevalence, Sarcopenia

Identifiers

Local EPrints ID: 473276
URI: http://eprints.soton.ac.uk/id/eprint/473276
ISSN: 2190-5991
PURE UUID: a3d98805-1ca3-4bc4-aef4-cb9106600bba
ORCID for Leo Westbury: ORCID iD orcid.org/0009-0008-5853-8096
ORCID for Elizabeth Curtis: ORCID iD orcid.org/0000-0002-5147-0550
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 13 Jan 2023 17:39
Last modified: 18 Mar 2024 03:38

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Contributors

Author: Leo Westbury ORCID iD
Author: Charlotte Beaudart
Author: Olivier Bruyère
Author: Jane A. Cauley
Author: Peggy M. Cawthon
Author: Alfonso Jose Cruz-Jentoft
Author: Kristine Ensrud
Author: Roger A. Fielding
Author: Helena Johansson
Author: John A. Kanis
Author: Magnus K. Karlsson
Author: Nancy E. Lane
Author: Laetitia Lengelé
Author: Mattias Lorentzon
Author: Eugene McCloskey
Author: Dan Mellström
Author: Anne B. Newman
Author: Claes Ohlsson
Author: Eric Orwoll
Author: Jean Yves Reginster
Author: Eva Ribom
Author: Bjorn E. Rosengren
Author: John T. Schousboe
Author: Eric J. Shiroma
Author: Nicholas Harvey ORCID iD
Author: Elaine Dennison ORCID iD
Author: Cyrus Cooper ORCID iD

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