Background/objectives: Sarcopenia is associated with poor health outcomes such as disability, institutionalization, and mortality. Efforts to manage sarcopenia clinically have been hindered by challenges in determining how to ascertain sarcopenia status correctly. The objective of this project was to assess the agreement between the different methods of ascertaining sarcopenia recommended by expert groups.
Design: Cross-sectional study of baseline data (2011-2015) from the Canadian Longitudinal Study on Aging.
Setting: Population-based multicenter study of community-dwelling participants.
Participants: Eligible participants (n = 12,646) aged 65 to 85 living within 25 to 50 km of 11 data collection sites in Canada. The analyses included 10,820 participants with the data required to diagnose sarcopenia.
Measurements: Sarcopenia was operationalized as appendicular lean mass (ALM), ALM and grip strength, ALM and gait speed, and grip strength and gait speed. Within each combination, ALM was adjusted for height squared, weight, body mass index, and the residual of regressing lean mass on height and fat mass. The lowest 20th sex-specific percentile values were used as the cutoffs for low ALM. Low grip strength cutoffs of 35.5 kg for men and 20 kg for women and a gait speed cutoff of .8 m/s were used.
Results: The mean age was 73.0 ± 5.6 years, and 51.9% of the sample was male. The agreement (Cohen's κ) between the different combinations of variables used to ascertain sarcopenia status was below .50. Agreement for the different lean mass adjustment techniques ranged from .04 to .76.
Conclusion: The combination of variables used to ascertain sarcopenia and many of the ALM adjustment techniques have insufficient agreement to be considered equivalent. This has important clinical implications for the management of sarcopenia because treatments may differ based on how sarcopenia is identified. To improve the clinical utility of sarcopenia, a unified definition of sarcopenia is required.
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Article Synopsis
- - The study investigates whether there is a causal relationship between sarcopenia (muscle loss) and cognitive impairment using a bidirectional Mendelian randomization approach, analyzing publicly available genetic data.
- - Results showed that factors like appendicular lean mass, walking pace, and grip strength are linked to cognitive performance, and that cognitive performance can also influence these muscle factors.
- - The findings support a clear cause-and-effect relationship between sarcopenia and cognitive impairment, highlighting the potential importance of muscle strengthening in preventing cognitive decline.
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Ward 1, Department of Gastroenterology, Zhoukou Central Hospital, Zhoukou City, Henan Province, China.
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Methods: Cohort studies of relevance were acquired through comprehensive searches of the Medline, Web of Science, and Embase databases. To account for heterogeneity, a random-effects model was employed to combine the findings.
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