Using minimal clinically important differences to measure long-term transitions of osteosarcopenia: The New Mexico Aging Process Study

Lara Vlietstra; Ben Kirk; Gustavo Duque; Clifford Qualls; Bruno Vellas; Sandrine Andrieu; John E Morley; Debra L Waters

doi:10.1016/j.exger.2023.112106

Using minimal clinically important differences to measure long-term transitions of osteosarcopenia: The New Mexico Aging Process Study

Exp Gerontol. 2023 Mar:173:112106. doi: 10.1016/j.exger.2023.112106. Epub 2023 Jan 26.

Authors

Lara Vlietstra¹, Ben Kirk², Gustavo Duque³, Clifford Qualls⁴, Bruno Vellas⁵, Sandrine Andrieu⁶, John E Morley⁷, Debra L Waters⁸

Affiliations

¹ School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand.
² Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia.
³ Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia; Research Institute of the McGill University Health Centre, McGill University, Montreal, QC H4A 3J1, Canada.
⁴ Department of Mathematics & Statistics and School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA.
⁵ Department of Internal and Geriatrics Medicine, Gerontopole, CHU de Toulouse, UMR 1295 INSERM, University Toulouse III, Toulouse, France; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA.
⁶ Department of Clinical Epidemiology and Public Health, CHU de Toulouse, UMR 1295 INSERM, University Toulouse III, Toulouse, France; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA.
⁷ Division of Geriatric Medicine, Saint Louis University, 1402, South Grand Blvd, RoomM238, St. Louis, MO 63110-0250, USA.
⁸ School of Physiotherapy, University of Otago, Dunedin, New Zealand; Department of Medicine, University of Otago, Dunedin, New Zealand; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA. Electronic address: debra.waters@otago.ac.nz.

PMID: 36708751
DOI: 10.1016/j.exger.2023.112106

Abstract

Background/objective: By having a better understanding of transitions in osteosarcopenia, interventions to reduce morbidity and mortality can be better targeted. The aim of this study was to show the rationale and method of using minimal clinically important differences (MCID's) to classify transitions, and the effects of demographic variables on transitions in a 9-year follow-up data from the New Mexico Aging Process Study (NMAPS).

Methods: Transitions were identified in four aspects of osteosarcopenia: bone mineral density (BMD), appendicular skeletal muscle mass/body mass index ratio (ASM/BMI), grip strength and gait speed. Transitions were identified using a MCID score. As there is currently no available MCID for BMD and ASM/BMI, those were determined using a distribution-based and an anchor-based method. Total transitions were calculated for all four measures of osteosarcopenia in all transition categories (maintaining a health status, beneficial transition, harmful transitions). Poisson regression was used to test for effects of demographic variables, including age, sex, physical activity, medication, and health status, on transitions.

Results: Over the 9-year follow-up, a total of 2163 MCID-derived BMD transitions were reported, 1689 ASM/BMI transitions, 2339 grip strength transitions, and 2151 gait speed transitions. Additionally, some MCID-derived transition categories were associated with sex, age, and health status.

Conclusion: Use of MCID-derived transitions reflected the fluctuation and the dynamic nature of health in older adults. Future research should focus on transitions of modifiable markers in osteosarcopenia to design intervention trials.

Keywords: Aging; Life course; MCID; Osteosarcopenia; Transitions.

Publication types

Review
Research Support, N.I.H., Extramural

MeSH terms

Aged
Body Mass Index
Bone Density / physiology
Humans
Minimal Clinically Important Difference*
New Mexico / epidemiology
Sarcopenia* / complications