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Identification of Sarcopenia Components That Discriminate Slow Walking Speed: A Pooled Data Analysis
Author(s) -
Manini Todd M.,
Patel Sheena M.,
Newman Anne B.,
Travison Thomas G.,
Kiel Douglas P.,
Shardell Michelle D.,
Pencina Karol M.,
Wilson Kevin E.,
Kelly Thomas L.,
Massaro Joseph M.,
Fielding Roger A.,
Magaziner Jay,
CorreadeAraujo Rosaly,
Kwok Timothy C.Y.,
Hirani Vasant,
Karlsson Magnus K.,
DʼAgostino Ralph B.,
Mellström Dan,
Ohlsson Claes,
Ribom Eva,
Jordan Joanne M.,
Bhasin Shalender,
Cawthon Peggy M.
Publication year - 2020
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.16524
Subject(s) - sarcopenia , medicine , preferred walking speed , grip strength , lean body mass , slowness , cart , regression analysis , gerontology , statistics , physical therapy , body weight , mathematics , mechanical engineering , physics , quantum mechanics , engineering
BACKGROUND The Sarcopenia Definitions and Outcomes Consortium (SDOC) sought to identify cut points for muscle strength and body composition measures derived from dual‐energy x‐ray absorptiometry (DXA) that discriminate older adults with slow walking speed. This article presents the core analyses used to guide the SDOC position statements. DESIGN Cross‐sectional data analyses of pooled data. SETTING University‐based research assessment centers. PARTICIPANTS Community‐dwelling men (n = 13,652) and women: (n = 5,115) with information on lean mass by DXA, grip strength (GR), and walking speed. MEASUREMENTS Thirty‐five candidate sarcopenia variables were entered into sex‐stratified classification and regression tree (CART) models to agnostically choose variables and cut points that discriminate slow walkers (<0.80 m/s). Models with alternative walking speed outcomes were also evaluated (<0.60 and <1.0 m/s and walking speed treated continuously). RESULTS CART models identified GR/body mass index (GRBMI) and GR/total body fat (GRTBF) as the primary discriminating variables for slowness in men and women, respectively. Men with GRBMI of 1.05 kg/kg/m 2 or less were approximately four times more likely to be slow walkers than those with GRBMI of greater than 1.05 kg/kg/m 2 . Women with GRTBF of less than 0.65 kg/kg were twice as likely to be slow walkers than women with GRTBF of 0.65 kg/kg or greater. Models with alternative walking speed outcomes selected only functions of GR as primary discriminators of slowness in both men and women. DXA‐derived lean mass measures did not consistently discriminate slow walkers. CONCLUSION GR with and without adjustments for body size and composition consistently discriminated older adults with slowness. CART models did not select DXA‐based lean mass as a primary discriminator of slowness. These results were presented to an SDOC Consensus Panel, who used them and other information to develop the SDOC Position Statements. J Am Geriatr Soc 68:1419‐1428, 2020.