Establishing the Link Between Lean Mass and Grip Strength Cut Points With Mobility Disability and Other Health Outcomes: Proceedings of the Sarcopenia Definition and Outcomes Consortium Conference

Peggy M Cawthon¹, Thomas G Travison², Todd M Manini³, Sheena Patel¹, Karol M Pencina⁴, Roger A Fielding⁵, Jay M Magaziner⁶, Anne B Newman⁷, Todd Brown⁸, Douglas P Kiel^{2

9}, Steve R Cummings¹, Michelle Shardell⁹, Jack M Guralnik⁶, Linda J Woodhouse¹⁰, Marco Pahor³, Ellen Binder¹¹, Ralph B D'Agostino¹², Xue Quian-Li¹³, Eric Orwoll¹⁴, Francesco Landi¹⁵, Denise Orwig⁶, Laura Schaap¹⁶, Nancy K Latham⁴, Vasant Hirani¹⁷, Timothy Kwok^{18

19}, Suzette L Pereira²⁰, Daniel Rooks²¹, Makoto Kashiwa²², Moises Torres-Gonzalez²³, Joseph P Menetski²⁴, Rosaly Correa-De-Araujo²⁵, Shalender Bhasin⁴

Affiliations

¹ California Pacific Medical Center Research Institute, San Francisco Coordinating Center, California.
² Department of Medicine, Marcus Institute for Aging Research, Hebrew SeniorLife, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
³ University of Florida, Gainesville.
⁴ Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
⁵ Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
⁶ Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore.
⁷ Department of Epidemiology, University of Pittsburgh, Pennsylvania.
⁸ Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University, Baltimore, Maryland.
⁹ Longitudinal Studies Section, The National Institute on Aging, Baltimore, Maryland.
¹⁰ Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
¹¹ Division of Geriatrics, Washington University School of Medicine, St Louis, Missouri.
¹² Department of Mathematics, Framingham Heart Study, Boston University, Massachusetts.
¹³ Director of Biostatistics, Division of Geriatric Medicine and Gerontology and Center on Aging and Health, Johns Hopkins Medical Institute, Baltimore, Maryland.
¹⁴ Division of Endocrinology, Metabolism and Clinical Nutrition, Oregon Health and Sciences University, Portland.
¹⁵ Department of Medicine and Geriatrics, Catholic University of Sacred Heart, Rome, Italy.
¹⁶ Faculty of Science, Nutrition and Health Aging and Later Life, Free University of Amsterdam, The Netherlands.
¹⁷ School of Life and Environmental Sciences, University of Sydney, Australia.
¹⁸ Department of Medicine and Therapeutics, Faculty of Medicine.
¹⁹ School of Public Health, The Chinese University of Hong Kong, China.
²⁰ Abbott Nutrition, Abbott Laboratories, Chicago, Illinois.
²¹ Novartis Biomedical Research Institute, Cambridge, Massachusetts.
²² Astellas Pharma Inc., Tokyo, Japan.
²³ National Dairy Council, Rosemont, Illinois.
²⁴ The Foundation for the National Institutes of Health, Bethesda, Maryland.
²⁵ The National Institute on Aging, Bethesda, Maryland.

PMID: 30869772
PMCID: PMC7447857
DOI: 10.1093/gerona/glz081

Establishing the Link Between Lean Mass and Grip Strength Cut Points With Mobility Disability and Other Health Outcomes: Proceedings of the Sarcopenia Definition and Outcomes Consortium Conference

Peggy M Cawthon et al. J Gerontol A Biol Sci Med Sci. 2020.

. 2020 Jun 18;75(7):1317-1323.

doi: 10.1093/gerona/glz081.

Authors

Affiliations

¹ California Pacific Medical Center Research Institute, San Francisco Coordinating Center, California.
² Department of Medicine, Marcus Institute for Aging Research, Hebrew SeniorLife, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
³ University of Florida, Gainesville.
⁴ Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
⁵ Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
⁶ Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore.
⁷ Department of Epidemiology, University of Pittsburgh, Pennsylvania.
⁸ Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University, Baltimore, Maryland.
⁹ Longitudinal Studies Section, The National Institute on Aging, Baltimore, Maryland.
¹⁰ Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
¹¹ Division of Geriatrics, Washington University School of Medicine, St Louis, Missouri.
¹² Department of Mathematics, Framingham Heart Study, Boston University, Massachusetts.
¹³ Director of Biostatistics, Division of Geriatric Medicine and Gerontology and Center on Aging and Health, Johns Hopkins Medical Institute, Baltimore, Maryland.
¹⁴ Division of Endocrinology, Metabolism and Clinical Nutrition, Oregon Health and Sciences University, Portland.
¹⁵ Department of Medicine and Geriatrics, Catholic University of Sacred Heart, Rome, Italy.
¹⁶ Faculty of Science, Nutrition and Health Aging and Later Life, Free University of Amsterdam, The Netherlands.
¹⁷ School of Life and Environmental Sciences, University of Sydney, Australia.
¹⁸ Department of Medicine and Therapeutics, Faculty of Medicine.
¹⁹ School of Public Health, The Chinese University of Hong Kong, China.
²⁰ Abbott Nutrition, Abbott Laboratories, Chicago, Illinois.
²¹ Novartis Biomedical Research Institute, Cambridge, Massachusetts.
²² Astellas Pharma Inc., Tokyo, Japan.
²³ National Dairy Council, Rosemont, Illinois.
²⁴ The Foundation for the National Institutes of Health, Bethesda, Maryland.
²⁵ The National Institute on Aging, Bethesda, Maryland.

PMID: 30869772
PMCID: PMC7447857
DOI: 10.1093/gerona/glz081

Abstract

Background: Lack of consensus on how to diagnose sarcopenia has limited the ability to diagnose this condition and hindered drug development. The Sarcopenia Definitions and Outcomes Consortium (SDOC) was formed to develop evidence-based diagnostic cut points for lean mass and/or muscle strength that identify people at increased risk of mobility disability. We describe here the proceedings of a meeting of SDOC and other experts to discuss strategic considerations in the development of evidence-based sarcopenia definition.

Methods: Presentations and panel discussions reviewed the usefulness of sarcopenia as a biomarker, the analytical approach used by SDOC to establish cut points, and preliminary findings, and provided strategic direction to develop an evidence-based definition of sarcopenia.

Results: The SDOC assembled data from eight epidemiological cohorts consisting of 18,831 participants, clinical populations from 10 randomized trials and observational studies, and 2 nationally representative cohorts. In preliminary assessments, grip strength or grip strength divided by body mass index was identified as discriminators of risk for mobility disability (walking speed <0.8 m/s), whereas dual-energy X-ray absorptiometry-derived lean mass measures were not good discriminators of mobility disability. Candidate definitions based on grip strength variables were associated with increased risk of mortality, falls, mobility disability, and instrumental activities of daily living disability. The prevalence of low grip strength increased with age. The attendees recommended the establishment of an International Expert Panel to review a series of position statements on sarcopenia definition that are informed by the findings of the SDOC analyses and synthesis of literature.

Conclusions: International consensus on an evidence-based definition of sarcopenia is needed. Grip strength-absolute or adjusted for body mass index-is an important discriminator of mobility disability and other endpoints. Additional research is needed to develop a predictive risk model that takes into account sarcopenia components as well as age, sex, race, and comorbidities.

Keywords: Grip strength cut-points; Lean mass cut-points; Mobility disability; Risk factors for mobility disability; Sarcopenia.

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Figures

**Figure 1.**
A schematic depiction of the analytic approach.

See this image and copyright information in PMC

References

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Establishing the Link Between Lean Mass and Grip Strength Cut Points With Mobility Disability and Other Health Outcomes: Proceedings of the Sarcopenia Definition and Outcomes Consortium Conference

Affiliations

Establishing the Link Between Lean Mass and Grip Strength Cut Points With Mobility Disability and Other Health Outcomes: Proceedings of the Sarcopenia Definition and Outcomes Consortium Conference

Authors

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Abstract

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References

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