Defining sarcopenia in terms of incident adverse outcomes

Abstract

Objectives: The objectives of this study were to compare the performance of different diagnoses of sarcopenia using European Working Group on Sarcopenia in Older People, International Working Group on Sarcopenia, and the US Foundation of National Institutes of Health (FNIH) criteria, and the screening tool SARC-F, against the Asian Working Group for Sarcopenia consensus panel definitions, in predicting physical limitation, slow walking speed, and repeated chair stand performance, days of hospital stay and mortality at follow up.

Design: Longitudinal study.

Setting: Community survey in Hong Kong.

Participants: Participants were 4000 men and women 65 years and older living in the community.

Measurements: Information from questionnaire regarding activities of daily living, physical functioning limitations, and constituent questions of SARC-F; body mass index (BMI), grip strength (GS), walking speed, and appendicular muscle mass (ASM).

Results: FNIH, consensus panel definitions, and the screening tool SARC-F all have similar AUC values in predicting incident physical limitation and physical performance measures at 4 years, walking speed at 7 years, days of hospital stay at 7 years, and mortality at 10 years. None of the definitions predicted increase in physical limitation at 4 years or mortality at 10 years in women, and none predicted all the adverse outcomes. The highest AUC values were observed for walking speed at 4 and 7 years.

Conclusion: When applied to a Chinese elderly population, criteria used for diagnosis of sarcopenia derived from European, Asian, and international consensus panels, from US cutoff values defined from incident physical limitation, and the SARC-F screening tool, all have similar performance in predicting incident physical limitation and mortality.

Keywords: Sarcopenia; appendicular muscle mass; grip strength; mortality; physical limitation; walking speed.