TY - JOUR
T1 - Criteria for clinically relevant weakness and low lean mass and their longitudinal association with incident mobility impairment and mortality
T2 - The Foundation for the National Institutes of Health (FNIH) sarcopenia project
AU - McLean, Robert R.
AU - Shardell, Michelle D.
AU - Alley, Dawn E.
AU - Cawthon, Peggy M.
AU - Fragala, Maren S.
AU - Harris, Tamara B.
AU - Kenny, Anne M.
AU - Peters, Katherine W.
AU - Ferrucci, Luigi
AU - Guralnik, Jack M.
AU - Kritchevsky, Stephen B.
AU - Kiel, Douglas P.
AU - Vassileva, Maria T.
AU - Xue, Qian Li
AU - Perera, Subashan
AU - Studenski, Stephanie A.
AU - Dam, Thuy Tien L.
N1 - Funding Information:
1Hebrew SeniorLife Institute for Aging Research, Boston, Massachusetts. 2Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. 3Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore. 4California Pacific Medical Center Research Institute, San Francisco. 5Center on Aging, University of Connecticut Health Center, Farmington. 6University of Central Florida, Orlando. 7Intramural Research Program of the National Institute on Aging, National Institutes of Health, Bethesda, Maryland. 8The Sticht Center on Aging and Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina. 9The Biomarkers Consortium, Foundation for the National Institutes of Health, Bethesda, Maryland. 10Division of Geriatric Medicine and Gerontology, School of Medicine Department of Medicine and the Center on Aging and Health, The Johns Hopkins University, Baltimore. 11Department of Internal Medicine, School of Medicine, University of Pittsburgh, Pennsylvania. 12VA Pittsburgh Healthcare System, Pennsylvania. 13Department of Medicine, College of Physicians and Surgeons, Columbia University, New York.
PY - 2014/5
Y1 - 2014/5
N2 - Background.This analysis sought to determine the associations of the Foundation for the National Institutes of Health Sarcopenia Project criteria for weakness and low lean mass with likelihood for mobility impairment (gait speed ≤ 0.8 m/s) and mortality. Providing validity for these criteria is essential for research and clinical evaluation.Methods.Among 4,411 men and 1,869 women pooled from 6 cohort studies, 3-year likelihood for incident mobility impairment and mortality over 10 years were determined for individuals with weakness, low lean mass, and for those having both. Weakness was defined as low grip strength (<26kg men and <16kg women) and low grip strength-to-body mass index (BMI; kg/m2) ratio (<1.00 men and <0.56 women). Low lean mass (dual-energy x-ray absorptiometry) was categorized as low appendicular lean mass (ALM; <19.75kg men and <15.02kg women) and low ALM-to-BMI ratio (<0.789 men and <0.512 women).Results.Low grip strength (men: odds ratio [OR] = 2.31, 95% confidence interval [CI] = 1.34-3.99; women: OR = 1.99, 95% CI 1.23-3.21), low grip strength-to-BMI ratio (men: OR = 3.28, 95% CI 1.92-5.59; women: OR = 2.54, 95% CI 1.10-5.83) and low ALM-to-BMI ratio (men: OR = 1.58, 95% CI 1.12-2.25; women: OR = 1.81, 95% CI 1.14-2.87), but not low ALM, were associated with increased likelihood for incident mobility impairment. Weakness increased likelihood of mobility impairment regardless of low lean mass. Mortality risk patterns were inconsistent.Conclusions.These findings support our cut-points for low grip strength and low ALM-to-BMI ratio as candidate criteria for clinically relevant weakness and low lean mass. Further validation in other populations and for alternate relevant outcomes is needed.
AB - Background.This analysis sought to determine the associations of the Foundation for the National Institutes of Health Sarcopenia Project criteria for weakness and low lean mass with likelihood for mobility impairment (gait speed ≤ 0.8 m/s) and mortality. Providing validity for these criteria is essential for research and clinical evaluation.Methods.Among 4,411 men and 1,869 women pooled from 6 cohort studies, 3-year likelihood for incident mobility impairment and mortality over 10 years were determined for individuals with weakness, low lean mass, and for those having both. Weakness was defined as low grip strength (<26kg men and <16kg women) and low grip strength-to-body mass index (BMI; kg/m2) ratio (<1.00 men and <0.56 women). Low lean mass (dual-energy x-ray absorptiometry) was categorized as low appendicular lean mass (ALM; <19.75kg men and <15.02kg women) and low ALM-to-BMI ratio (<0.789 men and <0.512 women).Results.Low grip strength (men: odds ratio [OR] = 2.31, 95% confidence interval [CI] = 1.34-3.99; women: OR = 1.99, 95% CI 1.23-3.21), low grip strength-to-BMI ratio (men: OR = 3.28, 95% CI 1.92-5.59; women: OR = 2.54, 95% CI 1.10-5.83) and low ALM-to-BMI ratio (men: OR = 1.58, 95% CI 1.12-2.25; women: OR = 1.81, 95% CI 1.14-2.87), but not low ALM, were associated with increased likelihood for incident mobility impairment. Weakness increased likelihood of mobility impairment regardless of low lean mass. Mortality risk patterns were inconsistent.Conclusions.These findings support our cut-points for low grip strength and low ALM-to-BMI ratio as candidate criteria for clinically relevant weakness and low lean mass. Further validation in other populations and for alternate relevant outcomes is needed.
KW - Impairment.
KW - Mobility
KW - Muscle
KW - Sarcopenia
UR - https://www.scopus.com/pages/publications/84899073317
UR - https://www.scopus.com/pages/publications/84899073317#tab=citedBy
U2 - 10.1093/gerona/glu012
DO - 10.1093/gerona/glu012
M3 - Article
C2 - 24737560
AN - SCOPUS:84899073317
SN - 1079-5006
VL - 69 A
SP - 576
EP - 583
JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
IS - 5
ER -