Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Feb;14(1):565-575.
doi: 10.1002/jcsm.13160. Epub 2023 Jan 5.

Recent sarcopenia definitions-prevalence, agreement and mortality associations among men: Findings from population-based cohorts

Leo D Westbury  1 , Charlotte Beaudart  2 , Olivier Bruyère  2 , Jane A Cauley  3 , Peggy Cawthon  4   5 , Alfonso J Cruz-Jentoft  6 , Elizabeth M Curtis  1 , Kristine Ensrud  7   8 , Roger A Fielding  9 , Helena Johansson  10   11 , John A Kanis  10   12 , Magnus K Karlsson  13 , Nancy E Lane  14 , Laetitia Lengelé  2 , Mattias Lorentzon  10   15 , Eugene McCloskey  10   16 , Dan Mellström  17 , Anne B Newman  3 , Claes Ohlsson  18   19 , Eric Orwoll  20 , Jean-Yves Reginster  2 , Eva Ribom  21 , Björn E Rosengren  13 , John T Schousboe  22   23 , Eric J Shiroma  24 , Nicholas C Harvey  1   25 , Elaine M Dennison  1   25   26 , Cyrus Cooper  1   25   27 ; International Musculoskeletal Ageing Network
Affiliations
Meta-Analysis

Recent sarcopenia definitions-prevalence, agreement and mortality associations among men: Findings from population-based cohorts

Leo D Westbury et al. J Cachexia Sarcopenia Muscle. 2023 Feb.

Abstract

Background: The 2019 European Working Group on Sarcopenia in Older People (EWGSOP2) and the Sarcopenia Definitions and Outcomes Consortium (SDOC) have recently proposed sarcopenia definitions. However, comparisons of the performance of these approaches in terms of thresholds employed, concordance in individuals and prediction of important health-related outcomes such as death are limited. We addressed this in a large multinational assembly of cohort studies that included information on lean mass, muscle strength, physical performance and health outcomes.

Methods: White men from the Health Aging and Body Composition (Health ABC) Study, Osteoporotic Fractures in Men (MrOS) Study cohorts (Sweden, USA), the Hertfordshire Cohort Study (HCS) and the Sarcopenia and Physical impairment with advancing Age (SarcoPhAge) Study were analysed. Appendicular lean mass (ALM) was ascertained using DXA; muscle strength by grip dynamometry; and usual gait speed over courses of 2.4-6 m. Deaths were recorded and verified. Definitions of sarcopenia were as follows: EWGSOP2 (grip strength <27 kg and ALM index <7.0 kg/m2 ), SDOC (grip strength <35.5 kg and gait speed <0.8 m/s) and Modified SDOC (grip strength <35.5 kg and gait speed <1.0 m/s). Cohen's kappa statistic was used to assess agreement between original definitions (EWGSOP2 and SDOC). Presence versus absence of sarcopenia according to each definition in relation to mortality risk was examined using Cox regression with adjustment for age and weight; estimates were combined across cohorts using random-effects meta-analysis.

Results: Mean (SD) age of participants (n = 9170) was 74.3 (4.9) years; 5929 participants died during a mean (SD) follow-up of 12.1 (5.5) years. The proportion with sarcopenia according to each definition was EWGSOP2 (1.1%), SDOC (1.7%) and Modified SDOC (5.3%). Agreement was weak between EWGSOP2 and SDOC (κ = 0.17). Pooled hazard ratios (95% CI) for mortality for presence versus absence of each definition were EWGSOP2 [1.76 (1.42, 2.18), I2 : 0.0%]; SDOC [2.75 (2.28, 3.31), I2 : 0.0%]; and Modified SDOC [1.93 (1.54, 2.41), I2 : 58.3%].

Conclusions: There was low prevalence and poor agreement among recent sarcopenia definitions in community-dwelling cohorts of older white men. All indices of sarcopenia were associated with mortality. The strong relationship between sarcopenia and mortality, regardless of the definition, illustrates that identification of appropriate management and lifecourse intervention strategies for this condition is of paramount importance.

Keywords: Ageing; Epidemiology; Mortality; Prevalence; Sarcopenia.

PubMed Disclaimer

Conflict of interest statement

Cyrus Cooper reports personal fees (outside the submitted work) from Amgen, Danone, Eli Lilly, GSK, Kyowa Kirin, Medtronic, Merck, Nestle, Novartis, Pfizer, Roche, Servier, Shire, Takeda and UCB. Elaine Dennison has received lecture fees and honoraria from UCB, Pfizer, Lilly and Viatris outside of the submitted work. Nicholas Harvey reports consultancy, lecture fees and honoraria (outside the submitted work) from Alliance for Better Bone Health, AMGEN, MSD, Eli Lilly, Servier, Shire, UCB, Kyowa Kirin, Consilient Healthcare, Radius Health and Internis Pharma. Roger Fielding reports grants from the National Institutes of Health (National Institute on Aging) and the USDA, during the conduct of the study; grants, personal fees and other from Axcella Health; other from Inside Tracker; grants and personal fees from Biophytis; grants and personal fees from Astellas; personal fees from Pfizer; personal fees from Reneo; personal fees from Cytokinetics; personal fees from Amazentis; grants and personal fees from Nestle; and personal fees from Glaxo Smith Kline, outside the submitted work. Jean‐Yves Reginster declares grant support from industry through institution (IBSA‐Genevrier, Mylan, CNIEL, Radius Health, TRB), lecture fees when speaking at the invitation of sponsor [IBSA‐Genevrier, Mylan, CNIEL, Dairy Research Council (DRC), Nutricia, Danone, Agnovos] and consulting fees or paid advisory boards (IBSA‐Genevrier, Mylan, Radius Health, Pierre Fabre, Faes Pharma, Rejuvenate Biomed, Samumed, Teva, Theramex, Pfizer, Mithra Pharmaceuticals). The remaining authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
EWGSOP2 and SDOC thresholds for components in relation to their distributions among white men. ALM, appendicular lean mass; EWGSOP2, 2019 European Working Group on Sarcopenia in Older People (grip strength <27 kg; ALM index <7.0 kg/m2); SDOC, Sarcopenia Definitions and Outcomes Consortium (grip strength <35.5 kg; gait speed <0.8 m/s). Darker shading indicates values below the specified thresholds; the percentages below the thresholds are stated in each graph.
Figure 2
Figure 2
Prevalence of sarcopenia components and definitions according to age bands among white men. ALMi, appendicular lean mass index (kg/m2); EWGSOP2, 2019 European Working Group on Sarcopenia in Older People; SDOC, Sarcopenia Definitions and Outcomes Consortium.
Figure 3
Figure 3
Original and modified EWGSOP2 and SDOC components and definitions in relation to risk of mortality among white men after adjustment for age and weight. ALMi, appendicular lean mass index (kg/m2); EWGSOP2, 2019 European Working Group on Sarcopenia in Older People; HCS, Hertfordshire Cohort Study; Health ABC, Health, Aging and Body Composition Study; MrOS, Osteoporotic Fractures in Men Study; SarcoPhAge, Sarcopenia and Physical impairment with advancing Age Study; SDOC, Sarcopenia Definitions and Outcomes Consortium. Estimates are missing for cohorts where no participants had the corresponding sarcopenia definition or component. Original EWGSOP2: grip strength <27 kg and ALM index <7.0 kg/m2; Modified EWGSOP2: grip strength <35.5 kg and ALM index <7.0 kg/m2. Original SDOC: grip strength <35.5 kg and gait speed <0.8 m/s; Modified SDOC: grip strength <35.5 kg and gait speed <1.0 m/s.
Figure 4
Figure 4
Original and modified EWGSOP2 definitions for probable, confirmed and severe sarcopenia in relation to risk of mortality among white men after adjustment for age and weight. ALMi, appendicular lean mass index (kg/m2); EWGSOP2, 2019 European Working Group on Sarcopenia in Older People; HCS, Hertfordshire Cohort Study; Health ABC, Health, Aging and Body Composition Study; MrOS, Osteoporotic Fractures in Men Study; SarcoPhAge, Sarcopenia and Physical impairment with advancing Age Study. Estimates are missing for cohorts where no participants had the corresponding sarcopenia definition. Original thresholds (graphs at the top of the figure): probable (grip strength <27 kg); confirmed (grip strength <27 kg and ALM index <7.0 kg/m2); and severe (grip strength <27 kg and ALM index <7.0 kg/m2 and gait speed ≤0.8 m/s). Modified thresholds for grip strength and gait speed are used in graphs at the bottom of the figure. Overall prevalence of the condition across all cohorts is stated in the graph subtitles in square brackets.
See this image and copyright information in PMC

References

    1. Shaw S, Dennison E, Cooper C. Epidemiology of sarcopenia: Determinants throughout the lifecourse. Calcif Tissue Int 2017;101:229–247. - PMC - PubMed
    1. Beaudart C, Biver E, Reginster J‐Y, Rizzoli R, Rolland Y, Bautmans I, et al. Development of a self‐administrated quality of life questionnaire for sarcopenia in elderly subjects: The SarQoL. Age Ageing 2015;44:960–966. - PMC - PubMed
    1. Cao L, Morley JE. Sarcopenia is recognized as an independent condition by an international classification of disease, tenth revision, clinical modification (ICD‐10‐CM) code. J Am Med Dir Assoc 2016;17:675–677. - PubMed
    1. Cruz‐Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010;39:412–423. - PMC - PubMed
    1. Cruz‐Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing 2019;48:16–31. - PMC - PubMed

Publication types

Grants and funding