Criteria for Clinically Relevant Weakness and Low Lean Mass and Their Longitudinal Association With Incident Mobility Impairment and Mortality: The Foundation for the National Institutes of Health (FNIH) Sarcopenia Project

    Authors

    R. R. McLean; M. D. Shardell; D. E. Alley; P. M. Cawthon; M. S. Fragala; T. B. Harris; A. M. Kenny; K. W. Peters; L. Ferrucci; J. M. Guralnik; S. B. Kritchevsky; D. P. Kiel; M. T. Vassileva; Q. L. Xue; S. Perera; S. A. Studenski;T. T. L. Dam

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    Abbreviated Journal Title

    J. Gerontol. Ser. A-Biol. Sci. Med. Sci.

    Keywords

    Muscle; Sarcopenia; Mobility; Impairment; LOWER-EXTREMITY FUNCTION; OSTEOPOROTIC FRACTURES; BODY-COMPOSITION; MUSCLE STRENGTH; OLDER PERSONS; WHITE WOMEN; MEN; EPIDEMIOLOGY; RISK; PERFORMANCE; Geriatrics & Gerontology; Gerontology

    Abstract

    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. 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/m(2)) 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). Low grip strength (men: odds ratio [OR] 2.31, 95% confidence interval [CI] 1.343.99; women: OR 1.99, 95% CI 1.233.21), low grip strength-to-BMI ratio (men: OR 3.28, 95% CI 1.925.59; women: OR 2.54, 95% CI 1.105.83) and low ALM-to-BMI ratio (men: OR 1.58, 95% CI 1.122.25; women: OR 1.81, 95% CI 1.142.87), 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. 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.

    Journal Title

    Journals of Gerontology Series a-Biological Sciences and Medical Sciences

    Volume

    69

    Issue/Number

    5

    Publication Date

    1-1-2014

    Document Type

    Article

    Language

    English

    First Page

    576

    Last Page

    583

    WOS Identifier

    WOS:000334738000010

    ISSN

    1079-5006

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