JAMDA Online
Original Study
Comparisons of Sarcopenia Defined by IWGS and EWGSOP Criteria Among Older People: Results From the I-Lan Longitudinal Aging Study

https://doi.org/10.1016/j.jamda.2013.03.019Get rights and content

Abstract

Objective

To compare clinical characteristics of sarcopenia defined by the International Working Group on Sarcopenia (IWGS) and European Working Group on Sarcopenia in Older People (EWGSOP) criteria among older people in Taiwan.

Design

A prospective population-based community study.

Setting

I-Lan County of Taiwan.

Participants

A total of 100 young healthy volunteers and 408 elderly people.

Intervention

None.

Measurements

Anthropometry, skeletal muscle mass measured by dual x-ray absorptiometry, relative appendicular skeletal muscle index (RASM), percentage skeletal muscle index (SMI), 6-meter walking speed, and handgrip strength.

Results

The prevalence of sarcopenia was 5.8% to 14.9% in men and 4.1% to 16.6% in women according to IWGS and EWGSOP criteria by using RASM or SMI as the muscle mass indices. The agreement of sarcopenia diagnosed by IWGS and EWGSOP criteria was only fair by using either RASM or SMI (kappa = 0.448 by RASM, kappa = 0.471 by SMI). The prevalence of sarcopenia was lower by the IWGS definition than the EWGSOP definition, but it was remarkably lower by using RASM than SMI in both criteria. Overall, sarcopenic individuals defined by SMI were older, had a higher BMI but similar total skeletal muscle mass, and had poorer muscle strength and physical performance than nonsarcopenic individuals. However, by using RASM, sarcopenic individuals had less total skeletal muscle mass but similar BMI than nonsarcopenic individuals. Multivariable logistic regression showed that age was the strongest associative factor for sarcopenia in both IWGS and EWGSOP criteria. Obesity played a neutral role in sarcopenia when it is defined by using RASM, but significantly increased the risk of sarcopenia in both criteria by using SMI.

Conclusion

The agreement of sarcopenia defined by IWGS and EWGSOP was only fair, and the prevalence varied largely by using different skeletal muscle mass indices. Proper selections for cutoff values of handgrip strength, walking speed, and skeletal muscle indices with full considerations of gender and ethnic differences were of critical importance to reach the universal diagnostic criteria for sarcopenia internationally.

Section snippets

Participants

The I-Lan Longitudinal Ageing Study (ILAS), a population-based aging cohort study, consisted of long-living middle-aged and elderly people in the I-Lan County of Taiwan. The ILAS intended to explore the complex interrelationship among aging, frailty, sarcopenia, and decline of cognitive function. Community-dwelling people aged 50 years and older were randomly sampled through the household registration data from I-Lan County. Research nurses invited sampled individuals to participate in the

Results

Among 100 young reference adults, the mean RASM (ASM/ht2) was 8.2 kg/m2 for men and 5.9 kg/m2 for women; and the mean SMI was 40% for men and 31% for women. The lower 20th percentiles of these measurements were defined as cutoff points of lower muscle mass, which were 7.27 kg/m2 for men and 5.44 kg/m2 for women by RASM and 37.4% for men and 28.0% for women by SMI (Table 1).

Overall, data of 386 elderly participants (mean age: 73.7 ± 5.6 years, 57.8% men) were retrieved for analysis. Table 2

Discussion

Currently, the prevalence of sarcopenia varies extensively when different definitions, instruments of measurements, methods of determining cutoff values, and gender are considered,14, 36, 37, 38, 39 which supports the need for a universal consensus of sarcopenia with full considerations of the aforementioned factors. Diagnostic criteria of IWGS and EWGSOP were the 2 commonly used definitions for sarcopenia; however, little was known regarding the evaluations of the consistency of the IWGS and

References (50)

  • P.J. Chen et al.

    Predicting cause-specific mortality of older men living in the Veteran Home by handgrip strength and walking speed: A 3-year prospective cohort study in Taiwan

    J Am Med Dir Assoc

    (2012)
  • M. Cesari et al.

    Sarcopenia: A novel clinical condition or still a matter for research?

    J Am Med Dir Assoc

    (2012)
  • I.H. Rosenberg et al.

    Stalking sarcopenia

    Ann Intern Med

    (1995)
  • M.A. Rogers et al.

    Changes in skeletal muscle with aging: Effects of exercise training

    Exerc Sport Sci Rev

    (1993)
  • J.L. Fleg et al.

    Role of muscle loss in the age-associated reduction in VO2 max

    J Appl Physiol

    (1988)
  • W.R. Frontera et al.

    Aging of skeletal muscle: A 12-yr longitudinal study

    J Appl Physiol

    (2000)
  • J.D. Walston

    Sarcopenia in older adults

    Curr Opin Rheumatol

    (2012)
  • A.P. Marsh et al.

    Muscle strength and BMI as predictors of major mobility disability in the Lifestyle Interventions and Independence for Elders pilot (LIFE-P)

    J Gerontol A Biol Sci Med Sci

    (2011)
  • Q.L. Xue et al.

    Prediction of risk of falling, physical disability, and frailty by rate of decline in grip strength: The Women's Health and Aging Study

    Arch Intern Med

    (2011)
  • B.H. Goodpaster et al.

    The loss of skeletal muscle strength, mass, and quality in older adults: The health, aging and body composition study

    J Gerontol A Biol Sci Med Sci

    (2006)
  • J. Woo et al.

    Defining sarcopenia in terms of risk of physical limitations: A 5-year follow-up study of 3,153 chinese men and women

    J Am Geriatr Soc

    (2009)
  • M. Cesari et al.

    Skeletal muscle and mortality results from the InCHIANTI Study

    J Gerontol A Biol Sci Med Sci

    (2009)
  • I. Janssen et al.

    The healthcare costs of sarcopenia in the United States

    J Am Geriatr Soc

    (2004)
  • A.J. Cruz-Jentoft et al.

    Understanding sarcopenia as a geriatric syndrome

    Curr Opin Clin Nutr Metab Care

    (2010)
  • C. Wang et al.

    Sarcopenia in the elderly: Basic and clinical issues

    Geriatr Gerontol Int

    (2012)
  • Cited by (0)

    The authors declare no conflicts of interest.

    View full text