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      Factors associated with skeletal muscle mass, sarcopenia, and sarcopenic obesity in older adults: a multi‐continent study

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          Abstract

          Background

          The aim of this study was to evaluate the factors associated with low skeletal muscle mass (SMM), sarcopenia, and sarcopenic obesity using nationally representative samples of people aged ≥65 years from diverse geographical regions of the world.

          Methods

          Data were available for 18 363 people aged ≥65 years who participated in the Collaborative Research on Ageing in Europe survey conducted in Finland, Poland, and Spain, and the World Health Organization Study on global AGEing and adult health survey conducted in China, Ghana, India, Mexico, Russia, and South Africa, between 2007 and 2012. A skeletal muscle mass index (SMI) was created to reflect SMM. SMM, SMI, and percent body fat (%BF) were calculated with specific indirect population formulas. These estimates were based on age, sex, weight, height, and race. Sarcopenia and sarcopenic obesity were defined with specific cut‐offs.

          Results

          The prevalence of sarcopenia ranged from 12.6% (Poland) to 17.5% (India), and that of sarcopenic obesity ranged from 1.3% (India) to 11.0% (Spain). Higher %BF was associated with lower SMM in all countries, and with sarcopenia in five countries ( p < 0.001). Compared to high levels of physical activity, low levels were related with higher odds for sarcopenia [OR 1.36 (95%CI 1.11–1.67)] and sarcopenic obesity [OR 1.80 (95%CI 1.23–2.64)] in the overall sample. Also, a dose‐dependent association between higher numbers of chronic diseases and sarcopenic obesity was observed.

          Conclusions

          Physical activity and body composition changes such as high %BF are key factors for the prevention of sarcopenia syndrome.

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          Epidemiology of sarcopenia among the elderly in New Mexico.

          R. Paul Ross, Markus Baumgartner, L. Romero … (1998)
          Muscle mass decreases with age, leading to "sarcopenia," or low relative muscle mass, in elderly people. Sarcopenia is believed to be associated with metabolic, physiologic, and functional impairments and disability. Methods of estimating the prevalence of sarcopenia and its associated risks in elderly populations are lacking. Data from a population-based survey of 883 elderly Hispanic and non-Hispanic white men and women living in New Mexico (the New Mexico Elder Health Survey, 1993-1995) were analyzed to develop a method for estimating the prevalence of sarcopenia. An anthropometric equation for predicting appendicular skeletal muscle mass was developed from a random subsample (n = 199) of participants and was extended to the total sample. Sarcopenia was defined as appendicular skeletal muscle mass (kg)/height2 (m2) being less than two standard deviations below the mean of a young reference group. Prevalences increased from 13-24% in persons under 70 years of age to >50% in persons over 80 years of age, and were slightly greater in Hispanics than in non-Hispanic whites. Sarcopenia was significantly associated with self-reported physical disability in both men and women, independent of ethnicity, age, morbidity, obesity, income, and health behaviors. This study provides some of the first estimates of the extent of the public health problem posed by sarcopenia.
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            Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability.

            Ian Janssen, Robert Ross, Steven B Heymsfield (2002)
            To establish the prevalence of sarcopenia in older Americans and to test the hypothesis that sarcopenia is related to functional impairment and physical disability in older persons. Cross-sectional survey. Nationally representative cross-sectional survey using data from the Third National Health and Nutrition Examination Survey (NHANES III). Fourteen thousand eight hundred eighteen adult NHANES III participants aged 18 and older. The presence of sarcopenia and the relationship between sarcopenia and functional impairment and disability were examined in 4,504 adults aged 60 and older. Skeletal muscle mass was estimated from bioimpedance analysis measurements and expressed as skeletal muscle mass index (SMI = skeletal muscle mass/body mass x 100). Subjects were considered to have a normal SMI if their SMI was greater than -one standard deviation above the sex-specific mean for young adults (aged 18-39). Class I sarcopenia was considered present in subjects whose SMI was within -one to -two standard deviations of young adult values, and class II sarcopenia was present in subjects whose SMI was below -two standard deviations of young adult values. The prevalence of class I and class II sarcopenia increased from the third to sixth decades but remained relatively constant thereafter. The prevalence of class I (59% vs 45%) and class II (10% vs 7%) sarcopenia was greater in the older (> or = 60 years) women than in the older men (P <.001). The likelihood of functional impairment and disability was approximately two times greater in the older men and three times greater in the older women with class II sarcopenia than in the older men and women with a normal SMI, respectively. Some of the associations between class II sarcopenia and functional impairment remained significant after adjustment for age, race, body mass index, health behaviors, and comorbidity. Reduced relative skeletal muscle mass in older Americans is a common occurrence that is significantly and independently associated with functional impairment and disability, particularly in older women. These observations provide strong support for the prevailing view that sarcopenia may be an important and potentially reversible cause of morbidity and mortality in older persons.
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              Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women.

              Matthew J. Delmonico, Tamara B. Harris, Jung-Sun Lee … (2007)
              To compare two methods for classifying an individual as sarcopenic for predicting decline in physical function in the Health, Aging and Body Composition Study. Observational cohort study with 5 years of follow-up. Communities in Memphis, Tennessee, and Pittsburgh, Pennsylvania. Men and women aged 70 to 79 (N=2,976, 52% women, 41% black). Appendicular lean mass (aLM) was measured using dual energy x-ray absorptiometry, and participants were classified as sarcopenic first using aLM divided by height squared and then using aLM adjusted for height and body fat mass (residuals). Incidence of persistent lower extremity limitation (PLL) was measured according to self-report, and change in objective lower extremity performance (LEP) measures were observed using the Short Physical Performance Battery. There was a greater risk of incident PLL in women who were sarcopenic using the residuals sarcopenia method than in women who were not sarcopenic (hazard ratio (HR)=1.34, 95% confidence interval (CI)=1.11-1.61) but not in men. Those defined as sarcopenic using the aLM/ht(2) method had lower incident PLL than nonsarcopenic men (HR=0.76, 95% CI=0.60-0.96) and women (HR=0.75, 95% CI=0.60-0.93), but these were no longer significant with adjustment for body fat mass. Using the residuals method, there were significantly poorer LEP scores in sarcopenic men and women at baseline and Year 6 and greater 5-year decline, whereas sarcopenic men defined using the aLM/ht(2) method had lower 5-year decline. Additional adjustment for fat mass attenuated this protective effect. These findings suggest that sarcopenia defined using the residuals method, a method that considers height and fat mass together, is better for predicting disability in an individual than the aLM/ht(2) method, because it considers fat as part of the definition.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Cachexia Sarcopenia Muscle
                Journal ID (iso-abbrev): J Cachexia Sarcopenia Muscle
                Journal ID (doi): 10.1007/13539.2190-6009
                Journal ID (publisher-id): JCSM
                Title: Journal of Cachexia, Sarcopenia and Muscle
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 2190-5991
                ISSN (Electronic): 2190-6009
                Publication date (Electronic): 07 October 2015
                Publication date (Print): June 2016
                Volume: 7
                Issue: 3 ( doiID: 10.1002/jcsm.v7.3 )
                Pages: 312-321
                Affiliations
                [ 1 ] Parc Sanitari Sant Joan de DéuUniversitat de Barcelona. Fundació Sant Joan de Déu Dr Antoni Pujades, 42 08830 Sant Boi de Llobregat BarcelonaSpain
                [ 2 ] Instituto de Salud Carlos IIICentro de Investigación Biomédica en Red de Salud Mental, CIBERSAM Monforte de Lemos 3‐5, Pabellón 11 28029 MadridSpain
                [ 3 ] Department of PsychiatryUniversidad Autónoma de Madrid, Instituto de Investigación Sanitaria Princesa (IP), Hospital Universitario la Princesa MadridSpain
                [ 4 ] Department of Health Statistics and Information SystemsWorld Health Organization GenevaSwitzerland
                [ 5 ] Department of Medical SociologyJagiellonian University Medical College KrakowPoland
                [ 6 ]National Institute for Health and Welfare HelsinkiFinland
                [ 7 ] Neurology, Public Health and Disability UnitNeurological Institute ‘Carlo Besta’ Foundation IRCCS (Istituto di ricovero e cura a carattere scientifico) MilanItaly
                Author notes
                [*] [* ]Correspondence to: Stefanos Tyrovolas, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain: Email: s.tyrovolas@ 123456pssjd.org
                Article
                Publisher ID: JCSM12076 Other ID: JCSM-D-15-00036
                DOI: 10.1002/jcsm.12076
                PMC ID: 4864288
                PubMed ID: 27239412
                SO-VID: 2169df22-1682-49a6-b610-964e8706b041
                Copyright © © 2015 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society of Sarcopenia, Cachexia and Wasting Disorders
                License:

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                Date received : 19 February 2015
                Date revision received : 10 August 2015
                Date accepted : 01 September 2015
                Page count
                Pages: 10
                Funding
                Funded by: United States National Institute on Aging's Division of Behavioral and Social Research through Interagency Agreements
                Award ID: OGHA 04034785
                Funded by: YA1323‐08‐CN‐0020
                Funded by: Y1‐AG‐1005‐01
                Funded by: WHO's Department of Health Statistics and Information Systems
                Funded by: European Community's Seventh Framework Programme
                Award ID: 223071
                Funded by: Instituto de Salud Carlos III‐FIS
                Award ID: PS09/00295
                Award ID: PS09/01845
                Funded by: Spanish Ministry of Science and Innovation ACI‐Promociona
                Award ID: ACI2009‐1010
                Funded by: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III
                Categories
                Subject: Original Article
                Subject: Original Articles
                Custom metadata
                source-schema-version-number 2.0
                component-id jcsm12076
                cover-date June 2016
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:4.9.1 mode:remove_FC converted:01.07.2016

                ScienceOpen disciplines: Orthopedics
                Keywords: skeletal muscle mass,sarcopenia,sarcopenic obesity,older adults
                Data availability:
                ScienceOpen disciplines: Orthopedics
                Keywords: skeletal muscle mass, sarcopenia, sarcopenic obesity, older adults

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