Utility of four sarcopenia criteria for the prediction of falls-related hospitalization in older Australian women

M Sim; R L Prince; D Scott; R M Daly; G Duque; C A Inderjeeth; K Zhu; R J Woodman; J M Hodgson; J R Lewis

doi:10.1007/s00198-018-4755-7

Utility of four sarcopenia criteria for the prediction of falls-related hospitalization in older Australian women

Osteoporos Int. 2019 Jan;30(1):167-176. doi: 10.1007/s00198-018-4755-7. Epub 2018 Nov 19.

Authors

M Sim^{1

2}, R L Prince^{3

4}, D Scott^{5

6}, R M Daly⁷, G Duque^{6

8}, C A Inderjeeth^{3

9}, K Zhu^{3

4}, R J Woodman¹⁰, J M Hodgson^{11

3}, J R Lewis^{11

3

12}

Affiliations

¹ School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia. marc.sim@ecu.edu.au.
² Medical School, The University Western Australia, Perth, Western Australia, Australia. marc.sim@ecu.edu.au.
³ Medical School, The University Western Australia, Perth, Western Australia, Australia.
⁴ Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
⁵ Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
⁶ Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School - Western Campus, The University of Melbourne, St Albans, Victoria, Australia.
⁷ Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
⁸ Department of Medicine-Western Health, The University of Melbourne, St Albans, Victoria, Australia.
⁹ North Metropolitan Health Service, Nedlands, Western Australia, Australia.
¹⁰ Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, South Australia, Australia.
¹¹ School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
¹² Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.

PMID: 30456572
DOI: 10.1007/s00198-018-4755-7

Abstract

Numerous sarcopenia definitions are not associated with increased falls-related hospitalization risk over 5 years to 9.5 years in older community-dwelling Australian women. Measures of muscle strength and physical function, but not appendicular lean mass (measured by dual-energy X-ray absorptiometry) may help discriminate the risk of falls-related hospitalization.

Introduction: The aim of this prospective, population-based cohort study of 903 Caucasian-Australian women (mean age 79.9 ± 2.6 years) was to compare the clinical utility of four sarcopenia definitions for the prediction of falls-related hospitalization over 9.5 years.

Methods: The four definitions were the United States Foundation for the National Institutes of Health (FNIH), the European Working Group on Sarcopenia in Older People (EWGSOP), and modified FNIH (AUS-POP_F) and EWGSOP (AUS-POP_E) definitions using Australian population-specific cut points (< 2 SD below the mean of young healthy Australian women). Components of sarcopenia including muscle strength, physical function, and appendicular lean mass (ALM) were quantified using hand grip strength, timed-up-and-go (TUG), and dual-energy X-ray absorptiometry (DXA), respectively. Incident 9.5-year falls-related hospitalization were captured by linked data.

Results: Baseline prevalence of sarcopenia according to FNIH (9.4%), EWGSOP (24.1%), AUS-POP_F (12.0%), and AUS-POP_E (10.7%) differed substantially. Sarcopenia did not increase the relative hazard ratio (HR) for falls-related hospitalization before or after adjustment for age (aHR): FNIH aHR 1.00 95%CI (0.69-1.47), EWGSOP aHR 1.20 95%CI (0.93-1.54), AUS-POP_F aHR 0.96 95%CI (0.68-1.35), and AUS-POP_E aHR 1.33 95%CI (0.94-1.88). When examining individual components of sarcopenia, only muscle strength and physical function but not ALM (adjusted for height² or BMI) were associated with falls-related hospitalization.

Conclusion: Current definitions of sarcopenia were not associated with falls-related hospitalization risk in this cohort of community-dwelling older Australian women. Finally, measures of muscle strength and physical function, but not ALM (measured by DXA) may help discriminate the risk of falls-related hospitalization.

Keywords: Falls-related hospitalization; Geriatrics; Muscle mass; Muscle strength; Physical function.

MeSH terms

Absorptiometry, Photon / methods
Accidental Falls / statistics & numerical data*
Aged
Aged, 80 and over
Female
Geriatric Assessment / methods
Hand Strength / physiology
Hospitalization / statistics & numerical data*
Humans
Independent Living
Kaplan-Meier Estimate
Muscle Strength / physiology
Muscle, Skeletal / physiopathology
Patient Readmission / statistics & numerical data
Physical Functional Performance
Prospective Studies
Risk Assessment / methods
Sarcopenia / diagnosis*
Sarcopenia / epidemiology
Sarcopenia / physiopathology
Western Australia / epidemiology

Abstract

MeSH terms

Grants and funding