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. 2014 Jun;127(6):547-53.
doi: 10.1016/j.amjmed.2014.02.007. Epub 2014 Feb 18.

Muscle mass index as a predictor of longevity in older adults

Preethi Srikanthan  1 , Arun S Karlamangla  2
Affiliations

Muscle mass index as a predictor of longevity in older adults

Preethi Srikanthan et al. Am J Med. 2014 Jun.

Abstract

Objective: Obesity (as defined by body mass index) has not been associated consistently with higher mortality in older adults. However, total body mass includes fat and muscle, which have different metabolic effects. This study was designed to test the hypothesis that greater muscle mass in older adults is associated with lower all-cause mortality.

Methods: All-cause mortality was analyzed by the year 2004 in 3659 participants from the National Health and Nutrition Examination Survey III who were aged 55 years or more (65 years if women) at the time of the survey (1988-1994). Individuals who were underweight or died in the first 2 years of follow-up were excluded to remove frail elders from the sample. Skeletal muscle mass was measured using bioelectrical impedance, and muscle mass index was defined as muscle mass divided by height squared. Modified Poisson regression and proportional hazards regression were used to examine the relationship of muscle mass index with all-cause mortality risk and rate, respectively, adjusted for central obesity (waist hip ratio) and other significant covariates.

Results: In adjusted analyses, total mortality was significantly lower in the fourth quartile of muscle mass index compared with the first quartile: adjusted risk ratio 0.81 (95% confidence interval, 0.71-0.91) and adjusted hazard ratio 0.80 (95% confidence interval, 0.66-0.97).

Conclusions: This study demonstrates the survival predication ability of relative muscle mass and highlights the need to look beyond total body mass in assessing the health of older adults.

Keywords: Mortality; Muscle.

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Conflict of interest statement

Conflict of interest statement: no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Kaplan Meier curves for survival by sex-specific quartiles of muscle mass index Muscle mass index quartile category cut-points: 6.2, 6.9 and 7.6 kg/m2 for women, and 9.2, 10.0 and 10.8 kg/m2 for men.
See this image and copyright information in PMC

Comment in

  • Muscle mass index revisited.
    Batsis JA. Batsis JA. Am J Med. 2014 Dec;127(12):e13. doi: 10.1016/j.amjmed.2014.07.013. Am J Med. 2014. PMID: 25481198 No abstract available.
  • The reply.
    Srikanthan P, Karlamangla AS. Srikanthan P, et al. Am J Med. 2014 Dec;127(12):e15. doi: 10.1016/j.amjmed.2014.08.013. Am J Med. 2014. PMID: 25481199 No abstract available.

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