Is sarcopenia associated with an increased risk of all-cause mortality and functional disability?

Abstract

Background: While a recent meta-analysis of observational studies reported a statistically significant association between sarcopenia and both all-cause mortality and functional decline, a recently developed inverse heterogeneity (IVhet) model has been shown to be more valid than the traditional random-effects model used.

Objective: The objective of this short report was to use a previous meta-analysis to compare the two approaches.

Methods: Aggregate data meta-analysis of prospective observational studies conducted in any setting. Men and women 60years of age and older in which all-cause mortality (12 studies, 14,169 participants) or functional decline (6 studies, 8561 participants) was assessed. Using the IVhet model, pooling of previous studies regarding the association between sarcopenia and all-cause mortality as well as functional decline. Absolute and relative differences between IVhet and random-effects results were also calculated as well as influence analysis with each study deleted once. Non-overlapping 95% confidence intervals (CI) for odds ratios (OR) were considered statistically significant.

Results: Sarcopenia was associated with an increased risk for all-cause mortality (OR=3.64, 95% CI=2.94 to 4.51) and functional decline (OR=2.58, 95% CI=1.33 to 4.99). Compared to the random-effects model, the OR was slightly higher (0.04 or 1.1%) but with wider CI (0.16 or 11.3%) for all-cause mortality and 0.45 (14.9%) lower with a CI that was 0.34 (10.2%) wider for functional decline. With each study deleted from the model once, results remained statistically significant for both all-cause mortality and functional decline.

Conclusion: These results provide additional and more accurate evidence in support of an association between sarcopenia and an increased risk for both all-cause mortality and functional decline.

Keywords: Aging; IVhet model; Meta-analysis; Mortality; Sarcopenia.

Figure 1

Forest plot for the association between sarcopenia and all-cause mortality using the IVhet model. The black squares represent the odds ratios (OR) while the left and right extremes of the squares represent the corresponding 95% confidence intervals for the OR. The middle of the black diamond represents the OR while the right and left extremes of the diamond represent the corresponding 95% confidence intervals. References for individual studies listed available from Beaudart et al. [4].

Figure 2

Forest plot for the association between sarcopenia and functional decline using the IVhet model. The black squares represent the odds ratios (OR) while the left and right extremes of the squares represent the corresponding 95% confidence intervals for the OR. The middle of the black diamond represents the OR while the right and left extremes of the diamond represent the corresponding 95% confidence intervals. References for individual studies listed available from Beaudart et al. [4].