Predictive value of sarcopenia components for all-cause mortality: findings from population-based cohorts

Predictive value of sarcopenia components for all-cause mortality: findings from population-based cohorts · SciRah

^aMRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
^bMRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK. nch@mrc.soton.ac.uk
^cNIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. nch@mrc.soton.ac.uk
^dDepartment of Biomedical Sciences, Clinical Pharmacology and Toxicology Research Unit, Namur Research Institute for Life Sciences (NARILIS), Faculty of Medicine, University of Namur, 5000, Namur, Belgium
^eDivision of Epidemiology, Public Health and Health Economics, Department of Public Health, University of Liège, Liège, Belgium
^fDepartment of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
^gDepartment of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
^hResearch Institute, California Pacific Medical Center, San Francisco, California, USA
ⁱServicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
^jCenter for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
^kMedicine and Epidemiology & Community Health, University of Minnesota, Minnesota, USA
^lNutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center On Aging, Tufts University, Boston, USA
^mMary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
ⁿSahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
^oCentre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
^pClinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences Malmo, Lund University and Department of Orthopedics, Skane University Hospital, Malmo, Sweden
^qDivision of Rheumatology, Department of Internal Medicine, UC Davis Health, 4625 Second Avenue, Sacramento, CA, 95917, USA
^rMetabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université catholique de Louvain, 1200 Sint-Lambrechts-Woluwe, Belgium
^sCenter for Osteoporosis Research, Institute of Medicine, Sahlgrenska Academy, Sahlgrenska University Hospital, Mölndal, Sweden
^tCentre for Integrated Research in Musculoskeletal Ageing (CIMA), Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK
^uCentre for Bone and Arthritis Research (CBAR), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
^vDepartment of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
^wRegion Västra Götaland, Sahlgrenska University Hospital, Department of Drug Treatment, Gothenburg, Sweden
^xOregon Health & Science University, Portland, Oregon, USA
^yProtein Research Chair, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
^zDepartment of Surgical Sciences, University of Uppsala, Uppsala, Sweden
^aaPark Nicollet Clinic and HealthPartners Institute, Bloomington, Minnesota, USA
^abUniversity of Minnesota, Minneapolis, Minnesota, USA
^acNIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
^adVictoria University of Wellington, Wellington, New Zealand
^aeNIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
✉Corresponding author

Abstract

BACKGROUND: Low grip strength and gait speed are associated with mortality. However, investigation of the additional mortality risk explained by these measures, over and above other factors, is limited. AIM: We examined whether grip strength and gait speed improve discriminative capacity for mortality over and above more readily obtainable clinical risk factors. METHODS: Participants from the Health, Aging and Body Composition Study, Osteoporotic Fractures in Men Study, and the Hertfordshire Cohort Study were analysed. Appendicular lean mass (ALM) was ascertained using DXA; muscle strength by grip dynamometry; and usual gait speed over 2.4-6 m. Verified deaths were recorded. Associations between sarcopenia components and mortality were examined using Cox regression with cohort as a random effect; discriminative capacity was assessed using Harrell's Concordance Index (C-index). RESULTS: Mean (SD) age of participants (n = 8362) was 73.8(5.1) years; 5231(62.6%) died during a median follow-up time of 13.3 years. Grip strength (hazard ratio (95% CI) per SD decrease: 1.14 (1.10,1.19)) and gait speed (1.21 (1.17,1.26)), but not ALM index (1.01 (0.95,1.06)), were associated with mortality in mutually-adjusted models after accounting for age, sex, BMI, smoking status, alcohol consumption, physical activity, ethnicity, education, history of fractures and falls, femoral neck bone mineral density (BMD), self-rated health, cognitive function and number of comorbidities. However, a model containing only age and sex as exposures gave a C-index (95% CI) of 0.65(0.64,0.66), which only increased to 0.67(0.67,0.68) after inclusion of grip strength and gait speed. CONCLUSIONS: Grip strength and gait speed may generate only modest adjunctive risk information for mortality compared with other more readily obtainable risk factors.

TL;DRGrip strength and gait speed may generate only modest adjunctive risk information for mortality compared with other more readily obtainable risk factors. (Semantic Scholar)

Predictive value of sarcopenia components for all-cause mortality: findings from population-based cohorts

Abstract

Plain-language summary

Discussion