Kidney function and other associated factors of sarcopenia in community-dwelling older adults: The SCOPE study

Rafael Moreno-González; Josep Maria Cruzado; Andrea Corsonello; Paolo Fabbietti; Lisanne Tap; Francesco Mattace-Raso; Johan Ärnlöv; Axel C Carlsson; Agnieszka Guligowska; Tomasz Kostka; Rada Artzi-Medvedik; Itshak Melzer; Regina Roller-Wirnsberger; Gerhard Wirnsberger; Robert Kob; Cornel Sieber; Fabrizia Lattanzio; Francesc Formiga; SCOPE investigators

doi:10.1016/j.ejim.2023.12.002

Kidney function and other associated factors of sarcopenia in community-dwelling older adults: The SCOPE study

Eur J Intern Med. 2023 Dec 15:S0953-6205(23)00432-6. doi: 10.1016/j.ejim.2023.12.002. Online ahead of print.

Authors

Rafael Moreno-González¹, Josep Maria Cruzado², Andrea Corsonello³, Paolo Fabbietti⁴, Lisanne Tap⁵, Francesco Mattace-Raso⁵, Johan Ärnlöv⁶, Axel C Carlsson⁷, Agnieszka Guligowska⁸, Tomasz Kostka⁸, Rada Artzi-Medvedik⁹, Itshak Melzer¹⁰, Regina Roller-Wirnsberger¹¹, Gerhard Wirnsberger¹¹, Robert Kob¹², Cornel Sieber¹², Fabrizia Lattanzio¹³, Francesc Formiga¹; SCOPE investigators

Affiliations

¹ Geriatric Unit, Internal Medicine Department, Hospital Universitari de Bellvitge, Systemic Diseases and Ageing Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona. L'Hospitalet de Llobregat, Barcelona, Spain.
² Nephrology Department, Hospital Universitari de Bellvitge. Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
³ Center for Biostatistic and Applied Geriatric Clinical Epidemiology, Italian National Research Center on Ageing (IRCCS INRCA), Ancona and Cosenza, Italy; Unit of Geriatric Medicine, Italian National Research Center on Ageing (IRCCS INRCA), Cosenza, Italy and Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy.
⁴ Center for Biostatistic and Applied Geriatric Clinical Epidemiology, Italian National Research Center on Ageing (IRCCS INRCA), Ancona and Cosenza, Italy.
⁵ Department of Internal Medicine, Section of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
⁶ School of Health and Social Studies, Dalarna University, Falun, Sweden; Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
⁷ Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden.
⁸ Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Poland.
⁹ Department of Nursing, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-sheva, Israel.
¹⁰ Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-sheva, Israel.
¹¹ Department of Internal Medicine, Medical University of Graz, Austria.
¹² Department of General Internal Medicine and Geriatrics, Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Regensburg, Germany.
¹³ Scientific Direction, Italian National Research Center on Aging (IRCCS INRCA), Ancona, Italy.

PMID: 38103954
DOI: 10.1016/j.ejim.2023.12.002

Abstract

Aim: Sarcopenia is associated with several factors and medical conditions among older adults, though previous research has shown limitations and inconsistencies, especially regarding chronic kidney disease (CKD). We investigated the clinical and laboratory variables associated with sarcopenia and severe sarcopenia in older adults, focusing on kidney function measures.

Methods: Data from community-dwelling adults aged ≥75 years participating in the SCOPE multicenter prospective cohort study were assessed cross-sectionally. Comprehensive geriatric assessment was conducted; sociodemographic and lifestyle factors, clinical variables and comorbidities, anthropometric and bioelectrical impedance analysis, blood and urine laboratory variables were collected. EWGSOP2 revised criteria were used to define sarcopenia and its severity. Estimated glomerular filtration rate (eGFR) was calculated using creatinine and non-creatinine-based equations, and CKD stages were defined accordingly.

Results: 1420 participants were included, prevalence of sarcopenia was 10.6 %, and 6 % had severe sarcopenia. Multivariate logistic regression analysis showed that age [OR =1.14; 95 %CI (1.09-1.19)], body mass index (BMI) [0.83 (0.79-0.88)], disability performing instrumental activities of daily living (IADL) [2.61 (1.69-4.06)], Mini Mental State Examination (MMSE) score <24 [2.75 (1.62-4.67)], osteoporosis [2.39 (1.55-3.67)], and stage 4 CKD defined by CKD-EPI_BTP-B2M, a non-creatinine-based eGFR equation [2.88 (1.11-7.49)], were independently associated with sarcopenia; as were specifically with severe sarcopenia, with more pronounced associations.

Conclusions: In community-dwelling older adults, sarcopenia is a relevant condition and is associated with severe CKD, older age, IADL, cognitive impairments, osteoporosis and low BMI. These factors should be assessed for proper identification and management of older patients with sarcopenia, and even more so with severe sarcopenia.

Keywords: Chronic kidney disease; Estimated glomerular filtration rate; Kidney function; Older adults; Sarcopenia; Severe sarcopenia.