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. 2022 Jul 18;22(1):597.
doi: 10.1186/s12877-022-03292-0.

Independent and joint associations of skeletal muscle mass and physical performance with all-cause mortality among older adults: a 12-year prospective cohort study

Chia-Ing Li  1   2 , Chiu-Shong Liu  1   2   3 , Chih-Hsueh Lin  1   3 , Shing-Yu Yang  4 , Tsai-Chung Li  5   6 , Cheng-Chieh Lin  7   8   9
Affiliations

Independent and joint associations of skeletal muscle mass and physical performance with all-cause mortality among older adults: a 12-year prospective cohort study

Chia-Ing Li et al. BMC Geriatr. .

Abstract

Background: Decreased skeletal muscle mass and low physical performance are independently associated with increased mortality in elderly individuals. However, little is known about the effects of skeletal muscle mass combined with physical performance on the prediction of mortality risk among community-dwelling older adults. This study aimed to determine the combined effects of skeletal muscle mass and physical performance on total mortality.

Methods: A community-based prospective cohort study was conducted among 641 participants aged 65 and older in 2009. The height-adjusted skeletal muscle index (hSMI) and the weight-adjusted SMI (wSMI) were determined by dual-energy X-ray absorptiometry examination. Physical performance tests measured at baseline included gait speed (GS), timed up-and-go (TUG) test, timed chair stand (TCS), weight-adjusted leg press (WaLP), and handgrip strength (HS). Cox proportional hazards regression models were applied to determine the adjusted hazard ratios (HRs) of mortality with 95% confidence intervals (95% CIs) for baseline skeletal muscle mass, physical performance, and traditional risk factors.

Results: During the follow-up of 12 years, 198 (30.89%) participants died. Low hSMI, low GS, high TUG, high TCS, low WaLP, and low HS were associated with high risks of mortality after the adjustment for confounders. The results of receiver operating characteristic (ROC) curve analyses revealed the values of ROC for models with additional consideration for TUG or all indicators significantly improved the discriminatory ability of mortality compared with the model with traditional factors (all P < 0.05). Elders with low hSMI and low GS (HRs = 4.33, 95% CI: 2.76-6.78), high TUG (4.11, 2.60-6.48), high TCS (2.97, 1.92-4.59), low WaLP (3.19, 2.13-4.79), and low HS (4.08, 2.70-6.17) were associated with high risks of mortality compared with those with high hSMI and their corresponding counterparts.

Conclusion: The hSMI and physical performance are significantly associated with increased risks of all-cause mortality. The combined use of hSMI and physical performance can provide improved risk stratification, which may be appropriately used as a screening tool targeting high-risk elders for the effective prevention of sarcopenia-related mortality.

Keywords: All-cause mortality; Physical performance; Skeletal muscle mass.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The areas under the receiver operating characteristic curves for all-cause mortality. The AUCs for models with additional consideration of TUG and all skeletal muscle mass and physical performance variables were significantly higher than that for model with baseline characteristics (p < 0.01)
Fig. 2
Fig. 2
Joint relationship of height-adjusted SMI with gait speed, TUG, TCS and WaLP on risk for all-cause mortality. Adjusted for age, sex, education, marital status, smoking, alcohol drinking, regular exercise, exercising program, hypertension, diabetes mellitus, heart disease, stroke, cancer, cognitive impairment, fasting plasma glucose, triglyceride, high-density lipoprotein, low-density lipoprotein, and estimated glomerular filtration rate. + : the highest HR group; -: the other group
See this image and copyright information in PMC

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