Evaluation of the usefulness of consensus definitions of sarcopenia in older men

Results from the observational osteoporotic fractures in men cohort study

Peggy M. Cawthon, Terri L. Blackwell, Jane Cauley, Deborah M. Kado, Elizabeth Barrett-Connor, Christine Lee, Andrew R. Hoffman, Michael Nevitt, Marcia L. Stefanick, Nancy E. Lane, Kristine E. Ensrud, Steven R. Cummings, Eric Orwoll

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Objective To evaluate the associations between definitions of sarcopenia and clinical outcomes and the ability of the definitions to discriminate those with a high likelihood of having these outcomes from those with a low likelihood. Design Osteoporotic Fractures in Men Study. Setting Six clinical centers. Participants Community-dwelling men aged 65 and older (N = 5,934). Measurements Sarcopenia definitions from the International Working Group, European Working Group on Sarcopenia in Older Persons, Foundation for the National Institutes of Health Sarcopenia Project, Baumgartner, and Newman were evaluated. Recurrent falls were defined as two or more self-reported falls in the year after baseline (n = 694, 11.9%). Incident hip fractures (n = 207, 3.5%) and deaths (n = 2,003, 34.1%) were confirmed according to central review of medical records over 9.8 years. Self-reported functional limitations were assessed at baseline and 4.6 years later. Logistic regression or proportional hazards models were used to estimate associations between sarcopenia and falls, hip fractures, and death. The discriminative ability of the sarcopenia definitions (vs reference models) for these outcomes was evaluated using area under the receiver operating characteristic curve or C-statistics. Referent models included age alone for falls, functional limitations and mortality, and age and bone mineral density for hip fractures. Results The association between sarcopenia according to the various definitions and risk of falls, functional limitations, and hip fractures was variable; all definitions were associated with greater risk of death, but none of the definitions materially changed discrimination based on the AUC and C-statistic when compared with reference models (change ≤1% in all models). Conclusion Sarcopenia definitions as currently constructed did not consistently improve prediction of clinical outcomes in relatively healthy older men.

Original languageEnglish (US)
Pages (from-to)2247-2259
Number of pages13
JournalJournal of the American Geriatrics Society
Volume63
Issue number11
DOIs
StatePublished - Nov 1 2015

Fingerprint

Sarcopenia
Osteoporotic Fractures
Cohort Studies
Hip Fractures
Independent Living
National Institutes of Health (U.S.)
Proportional Hazards Models
ROC Curve
Bone Density
Area Under Curve
Medical Records
Logistic Models
Mortality

Keywords

  • falls
  • fractures
  • functional limitation
  • mortality
  • sarcopenia

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Evaluation of the usefulness of consensus definitions of sarcopenia in older men : Results from the observational osteoporotic fractures in men cohort study. / Cawthon, Peggy M.; Blackwell, Terri L.; Cauley, Jane; Kado, Deborah M.; Barrett-Connor, Elizabeth; Lee, Christine; Hoffman, Andrew R.; Nevitt, Michael; Stefanick, Marcia L.; Lane, Nancy E.; Ensrud, Kristine E.; Cummings, Steven R.; Orwoll, Eric.

In: Journal of the American Geriatrics Society, Vol. 63, No. 11, 01.11.2015, p. 2247-2259.

Research output: Contribution to journalArticle

Cawthon, PM, Blackwell, TL, Cauley, J, Kado, DM, Barrett-Connor, E, Lee, C, Hoffman, AR, Nevitt, M, Stefanick, ML, Lane, NE, Ensrud, KE, Cummings, SR & Orwoll, E 2015, 'Evaluation of the usefulness of consensus definitions of sarcopenia in older men: Results from the observational osteoporotic fractures in men cohort study', Journal of the American Geriatrics Society, vol. 63, no. 11, pp. 2247-2259. https://doi.org/10.1111/jgs.13788
Cawthon, Peggy M. ; Blackwell, Terri L. ; Cauley, Jane ; Kado, Deborah M. ; Barrett-Connor, Elizabeth ; Lee, Christine ; Hoffman, Andrew R. ; Nevitt, Michael ; Stefanick, Marcia L. ; Lane, Nancy E. ; Ensrud, Kristine E. ; Cummings, Steven R. ; Orwoll, Eric. / Evaluation of the usefulness of consensus definitions of sarcopenia in older men : Results from the observational osteoporotic fractures in men cohort study. In: Journal of the American Geriatrics Society. 2015 ; Vol. 63, No. 11. pp. 2247-2259.
@article{6459ebfd829a4f088b06d29fcc6e6058,
title = "Evaluation of the usefulness of consensus definitions of sarcopenia in older men: Results from the observational osteoporotic fractures in men cohort study",
abstract = "Objective To evaluate the associations between definitions of sarcopenia and clinical outcomes and the ability of the definitions to discriminate those with a high likelihood of having these outcomes from those with a low likelihood. Design Osteoporotic Fractures in Men Study. Setting Six clinical centers. Participants Community-dwelling men aged 65 and older (N = 5,934). Measurements Sarcopenia definitions from the International Working Group, European Working Group on Sarcopenia in Older Persons, Foundation for the National Institutes of Health Sarcopenia Project, Baumgartner, and Newman were evaluated. Recurrent falls were defined as two or more self-reported falls in the year after baseline (n = 694, 11.9{\%}). Incident hip fractures (n = 207, 3.5{\%}) and deaths (n = 2,003, 34.1{\%}) were confirmed according to central review of medical records over 9.8 years. Self-reported functional limitations were assessed at baseline and 4.6 years later. Logistic regression or proportional hazards models were used to estimate associations between sarcopenia and falls, hip fractures, and death. The discriminative ability of the sarcopenia definitions (vs reference models) for these outcomes was evaluated using area under the receiver operating characteristic curve or C-statistics. Referent models included age alone for falls, functional limitations and mortality, and age and bone mineral density for hip fractures. Results The association between sarcopenia according to the various definitions and risk of falls, functional limitations, and hip fractures was variable; all definitions were associated with greater risk of death, but none of the definitions materially changed discrimination based on the AUC and C-statistic when compared with reference models (change ≤1{\%} in all models). Conclusion Sarcopenia definitions as currently constructed did not consistently improve prediction of clinical outcomes in relatively healthy older men.",
keywords = "falls, fractures, functional limitation, mortality, sarcopenia",
author = "Cawthon, {Peggy M.} and Blackwell, {Terri L.} and Jane Cauley and Kado, {Deborah M.} and Elizabeth Barrett-Connor and Christine Lee and Hoffman, {Andrew R.} and Michael Nevitt and Stefanick, {Marcia L.} and Lane, {Nancy E.} and Ensrud, {Kristine E.} and Cummings, {Steven R.} and Eric Orwoll",
year = "2015",
month = "11",
day = "1",
doi = "10.1111/jgs.13788",
language = "English (US)",
volume = "63",
pages = "2247--2259",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "11",

}

TY - JOUR

T1 - Evaluation of the usefulness of consensus definitions of sarcopenia in older men

T2 - Results from the observational osteoporotic fractures in men cohort study

AU - Cawthon, Peggy M.

AU - Blackwell, Terri L.

AU - Cauley, Jane

AU - Kado, Deborah M.

AU - Barrett-Connor, Elizabeth

AU - Lee, Christine

AU - Hoffman, Andrew R.

AU - Nevitt, Michael

AU - Stefanick, Marcia L.

AU - Lane, Nancy E.

AU - Ensrud, Kristine E.

AU - Cummings, Steven R.

AU - Orwoll, Eric

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Objective To evaluate the associations between definitions of sarcopenia and clinical outcomes and the ability of the definitions to discriminate those with a high likelihood of having these outcomes from those with a low likelihood. Design Osteoporotic Fractures in Men Study. Setting Six clinical centers. Participants Community-dwelling men aged 65 and older (N = 5,934). Measurements Sarcopenia definitions from the International Working Group, European Working Group on Sarcopenia in Older Persons, Foundation for the National Institutes of Health Sarcopenia Project, Baumgartner, and Newman were evaluated. Recurrent falls were defined as two or more self-reported falls in the year after baseline (n = 694, 11.9%). Incident hip fractures (n = 207, 3.5%) and deaths (n = 2,003, 34.1%) were confirmed according to central review of medical records over 9.8 years. Self-reported functional limitations were assessed at baseline and 4.6 years later. Logistic regression or proportional hazards models were used to estimate associations between sarcopenia and falls, hip fractures, and death. The discriminative ability of the sarcopenia definitions (vs reference models) for these outcomes was evaluated using area under the receiver operating characteristic curve or C-statistics. Referent models included age alone for falls, functional limitations and mortality, and age and bone mineral density for hip fractures. Results The association between sarcopenia according to the various definitions and risk of falls, functional limitations, and hip fractures was variable; all definitions were associated with greater risk of death, but none of the definitions materially changed discrimination based on the AUC and C-statistic when compared with reference models (change ≤1% in all models). Conclusion Sarcopenia definitions as currently constructed did not consistently improve prediction of clinical outcomes in relatively healthy older men.

AB - Objective To evaluate the associations between definitions of sarcopenia and clinical outcomes and the ability of the definitions to discriminate those with a high likelihood of having these outcomes from those with a low likelihood. Design Osteoporotic Fractures in Men Study. Setting Six clinical centers. Participants Community-dwelling men aged 65 and older (N = 5,934). Measurements Sarcopenia definitions from the International Working Group, European Working Group on Sarcopenia in Older Persons, Foundation for the National Institutes of Health Sarcopenia Project, Baumgartner, and Newman were evaluated. Recurrent falls were defined as two or more self-reported falls in the year after baseline (n = 694, 11.9%). Incident hip fractures (n = 207, 3.5%) and deaths (n = 2,003, 34.1%) were confirmed according to central review of medical records over 9.8 years. Self-reported functional limitations were assessed at baseline and 4.6 years later. Logistic regression or proportional hazards models were used to estimate associations between sarcopenia and falls, hip fractures, and death. The discriminative ability of the sarcopenia definitions (vs reference models) for these outcomes was evaluated using area under the receiver operating characteristic curve or C-statistics. Referent models included age alone for falls, functional limitations and mortality, and age and bone mineral density for hip fractures. Results The association between sarcopenia according to the various definitions and risk of falls, functional limitations, and hip fractures was variable; all definitions were associated with greater risk of death, but none of the definitions materially changed discrimination based on the AUC and C-statistic when compared with reference models (change ≤1% in all models). Conclusion Sarcopenia definitions as currently constructed did not consistently improve prediction of clinical outcomes in relatively healthy older men.

KW - falls

KW - fractures

KW - functional limitation

KW - mortality

KW - sarcopenia

UR - http://www.scopus.com/inward/record.url?scp=84948418756&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84948418756&partnerID=8YFLogxK

U2 - 10.1111/jgs.13788

DO - 10.1111/jgs.13788

M3 - Article

VL - 63

SP - 2247

EP - 2259

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

IS - 11

ER -