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Agreement and Predictive Validity Using Less‐Conservative Foundation for the National Institutes of Health Sarcopenia Project Weakness Cutpoints
Author(s) -
Chiles Shaffer Nancy,
Ferrucci Luigi,
Shardell Michelle,
Simonsick Eleanor M.,
Studenski Stephanie
Publication year - 2017
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14706
Subject(s) - medicine , sarcopenia , grip strength , confidence interval , lean body mass , weakness , hazard ratio , gerontology , physical therapy , body mass index , surgery , body weight
Objectives To derive lean mass cutpoints based on a less‐conservative Foundation for the National Institutes of Health ( FNIH ) Sarcopenia Project Weakness cutpoint for grip strength (Weak I ) and to assess their agreement with European Working Group on Sarcopenia in Older People ( EWGSOP ) and prediction of incident slow walking and mortality. Design Longitudinal analysis. Setting Baltimore Longitudinal Study of Aging. Participants Individuals aged 65 and older (287 men, 258 women) with 2 to 10 years of follow‐up. Measurements Weakness was determined according to handgrip strength using a hand dynamometer, appendicular lean mass ( ALM ) using dual‐energy X‐ray absorptiometry, and walking speed according to 6‐m usual pace walk speed. Analyses were performed using classification and regression tree analysis, Cohen's kappa, and Cox models. Results Cutpoints derived from Weak I for ALM ( ALM I ) were less than 21.4 kg in men and less than 14.1 kg in women and for ALM adjusted for body mass index ( ALM / BMI I ) were less than 0.725 in men and less than 0.591 in women. Kappas with EWGSOP were 0.65 for men and 0.75 for women for ALM I and 0.34 for men and 0.47 for women for ALM / BMI I . Men with Weak I + ALM I were twice as likely to develop slow walking as those not weak with normal ALM I (Hazard ratio (HR) = 2.44, 95% confidence interval (CI) = 1.02‐5.82). Under EWGSOP, men with weakness and low RALM were almost 3 times as likely to develop slow walking as those not weak with normal RALM (HR = 2.91, 95% CI = 1.11‐7.62). Neither approach predicted incident slow walking in women. Conclusion The ALM I cutpoints agree with EWGSOP and predict slow walking in men. Future studies should explore sex differences in the relationship between body composition and physical function and the effect of change in muscle mass on muscle strength and physical function.