Relationships between level and change in sarcopenia and other body composition components and adverse health outcomes: findings from the health, aging, and body composition study

Authors: WESTBURY, LEO - University Of Southampton; SYDDALL, HOLLY - University Of Southampton; FUGGLE, NICHOLAS - University Of Southampton; DENNISON, ELAINE - University Of Southampton; HARVEY, NICHOLAS - University Of Southampton; CAULEY, JANE - University Of Pittsburgh; SHIROMA, ERIC - National Institute On Aging (NIA, NIH); FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; NEWMAN, ANNE - University Of Pittsburgh; COOPER, CYRUS - University Of Southampton

Submitted to: Calcified Tissues International
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/27/2020
Publication Date: 11/15/2020
Citation: Westbury, L.D., Syddall, H.E., Fuggle, N.R., Dennison, E.M., Harvey, N.C., Cauley, J.A., Shiroma, E.J., Fielding, R., Newman, A.B., Cooper, C. 2020. Relationships between level and change in sarcopenia and other body composition components and adverse health outcomes: findings from the health, aging, and body composition study. Calcified Tissues International. 108:302-313. https://doi.org/10.1007/s00223-020-00775-3.
DOI: https://doi.org/10.1007/s00223-020-00775-3

Interpretive Summary: Sarcopenia is the age-associated decline in muscle mass and strength. We examined how baseline values and rates of decline in the components of sarcopenia (muscle mass, fat mass, handgrip strength, and walking speed) predict adverse clinical outcomes (death, hospital admissions, bone fracture, and falls) using a large population-based cohort study, the Health, Aging and Body Composition Study (HABC). A total 2689 participants aged 70-79 years from HABC were studied. Lower levels at baseline and greater declines in muscle mass, strength, and walking speed were associated with increased risk of death. Predictors of hospital admission included lower levels and greater declines in gait speed and grip strength. Lower gait speed, higher fat mass and both lower levels and greater declines in grip strength predicted recurrent falls. Lower baseline levels and greater declines in components of sarcopenia predicted adverse outcomes. Interventions to maximize muscle mass, strength, and walking speed in earlier life may reduce the burden of disease in this age group.

Technical Abstract: We investigated how baseline values and rates of decline in components of sarcopenia and other body composition parameters relate to adverse clinical outcomes using the Health, Aging, and Body Composition Study. 2689 participants aged 70-79 years were studied. Appendicular lean mass, whole body fat mass, and total hip BMD were ascertained using DXA; muscle strength by grip dynamometry; and muscle function by gait speed. Baseline values and 2-3 year conditional changes (independent of baseline) in each characteristic were examined as predictors of mortality, hospital admission, low trauma fracture, and recurrent falls in the subsequent 10-14 years using Cox regression (generalized estimating equations used for recurrent falls) with adjustment for sex, ethnicity, age, and potential confounders. Lower levels and greater declines in all parameters (excluding hip BMD level) were associated (p 0.05) with increased rates of mortality; fully-adjusted hazard ratios per SD lower gait speed and grip strength were 1.27 (95% CI 1.19, 1.36) and 1.14 (1.07, 1.21), respectively. Risk factors of hospital admission included lower levels and greater declines in gait speed and grip strength, and greater declines in hip BMD. Lower levels and greater declines in fat mass and hip BMD were associated with low trauma fracture. Lower gait speed, higher fat mass, and both lower levels and greater declines in grip strength were related to recurrent falls. Lower baseline levels and greater declines in musculoskeletal parameters were related to adverse outcomes. Interventions to maximize peak levels in earlier life and reduce rates of age-related decline may reduce the burden of disease in this age group.