Sarcopenia definition: The position statements of the sarcopenia definition and outcomes consortium

Authors: BHASIN, SHALENDER - BRIGHAM & WOMEN'S HOSPITAL; TRAVISON, THOMAS - HEBREW SENIOR LIFE; MANINI, TODD - UNIVERSITY OF FLORIDA; PATEL, SHEENA - CALIFORNIA PACIFIC MEDICAL CENTER RESEARCH INSTITUTE; PENCINA, KAROL - BRIGHAM & WOMEN'S HOSPITAL; FIELDING, ROGER - JEAN MAYER HUMAN NUTRITION RESEARCH CENTER ON AGING AT TUFTS UNIVERSITY; MAGAZINER, JAY - UNIVERSITY OF MARYLAND; NEWMAN, ANNE - UNIVERSITY OF PITTSBURGH; KIEL, DOUGLAS - HEBREW SENIOR LIFE; COOPER, CYRUS - UNIVERSITY OF SOUTHAMPTON; GURALNIK, JACK - UNIVERSITY OF MARYLAND; CAULEY, JANE - UNIVERSITY OF PITTSBURGH; ARAI, HIDENORI - GERONTOLOGY RESEARCH CENTER; CLARK, BRIAN - OHIO UNIVERSITY; LANDI, FRANCESCO - CATHOLIC UNIVERSITY OF THE SACRED HEART ITALY; SCHAAP, LAURA - VRIJE UNIVERSITY; PEREIRA, SUZETTE - ABBOTT LABORATORIES; ROOKS, DANIEL - NOVARTIS INSTITUTES; WOO, JEAN - THE CHINESE UNIVERSITY OF HONG KONG (CUHK); WOODHOUSE, LINDA - UNIVERSITY OF ALBERTA; BINDER, ELLEN - WASHINGTON UNIVERSITY; BROWN, TODD - JOHNS HOPKINS UNIVERSITY; SHARDELL, MICHELLE - NATIONAL INSTITUTE ON AGING (NIA, NIH); XUE, QUIAN-LI - JOHNS HOPKINS UNIVERSITY; D'AGOSTINO SR., RALPH - FRAMINGHAM HEART STUDY; ORWIG, DENISE - UNIVERSITY OF MARYLAND; GROSICKI, GREG - GEORGIA SOUTHERN UNIVERSITY; CORREA-DE-ARAUJO, ROSALY - NATIONAL INSTITUTE ON AGING (NIA, NIH); CAWTHON, PEGGY - CALIFORNIA PACIFIC MEDICAL CENTER RESEARCH INSTITUTE

Submitted to: Journal of the American Geriatrics Society
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/2/2020
Publication Date: 3/9/2020
Citation: Bhasin, S., Travison, T.G., Manini, T.M., Patel, S., Pencina, K.M., Fielding, R.A., Magaziner, J.M., Newman, A.B., Kiel, D.P., Cooper, C., Guralnik, J.M., Cauley, J.A., Arai, H., Clark, B.C., Landi, F., Schaap, L.A., Pereira, S.L., Rooks, D., Woo, J., Woodhouse, L.J., Binder, E., Brown, T., Shardell, M., Xue, Q., D'Agostino Sr., R.B., Orwig, D., Grosicki, G., Correa-de-Araujo, R., Cawthon, P.M. 2020. Sarcopenia definition: The position statements of the sarcopenia definition and outcomes consortium. Journal of the American Geriatrics Society. 68:1410-1418. https://doi.org/10.1111/jgs.16372.
DOI: https://doi.org/10.1111/jgs.16372

Interpretive Summary: Analyses performed by the Sarcopenia Definitions and Outcomes Consortium (SDOC) crafted a set of position statements informed by a literature review and SDOC's analyses of eight population studies, six clinical trials, four studies of special populations, and two nationally representative population-based studies. The SDOC analyses identified grip strength as an important predictor of slow walking speed. Both low grip strength and slow walking speed (less than 0.8 meters per second) independently predicted falls, limitations in mobility, hip fractures, and mortality (death) in community-dwelling older adults. Lean/muscle mass was not associated with adverse health-related outcomes (falls, limitations in mobility, hip fractures, and mortality (death) in community-dwelling older adults. The panel agreed that both weakness defined by low grip strength and slowness defined by slow walking speed should be included in the definition of sarcopenia. These position statements offer a rational basis for an evidence-based definition of sarcopenia.

Technical Abstract: OBJECTIVES: To develop an evidence-based definition of sarcopenia that can facilitate identification of older adults at risk for clinically relevant outcomes (eg, self-reported mobility limitation, falls, fractures, and mortality), the Sarcopenia Definition and Outcomes Consortium (SDOC) crafted a set of position statements informed by a literature review and SDOC's analyses of eight epidemiologic studies, six randomized clinical trials, four cohort studies of special populations, and two nationally representative population-based studies. METHODS: Thirteen position statements related to the putative components of a sarcopenia definition, informed by the SDOC analyses and literature synthesis, were reviewed by an independent international expert panel (panel) iteratively and voted on by the panel during the Sarcopenia Position Statement Conference. Four position statements related to grip strength, three to lean mass derived from dual-energy x-ray absorptiometry (DXA), and four to gait speed; two were summary statements. RESULTS: The SDOC analyses identified grip strength, either absolute or scaled to measures of body size, as an important discriminator of slowness. Both low grip strength and low usual gait speed independently predicted falls, self-reported mobility limitation, hip fractures, and mortality in community-dwelling older adults. Lean mass measured by DXA was not associated with incident adverse health-related outcomes in community-dwelling older adults with or without adjustment for body size. CONCLUSION: The panel agreed that both weakness defined by low grip strength and slowness defined by low usual gait speed should be included in the definition of sarcopenia. These position statements offer a rational basis for an evidence-based definition of sarcopenia. The analyses that informed these position statements are summarized in this article and discussed in accompanying articles in this issue of the journal.