title: The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates.
abstract: BACKGROUND
  Low muscle mass and weakness are common and potentially disabling in older adults, but in order to become recognized as a clinical condition, criteria for diagnosis should be based on clinically relevant thresholds and independently validated. The Foundation for the National Institutes of Health Biomarkers Consortium Sarcopenia Project used an evidence-based approach to develop these criteria. Initial findings were presented at a conference in May 2012, which generated recommendations that guided additional analyses to determine final recommended criteria. Details of the Project and its findings are presented in four accompanying manuscripts.
  
  
  METHODS
  The Foundation for the National Institutes of Health Sarcopenia Project used data from nine sources of community-dwelling older persons: Age, Gene/Environment Susceptibility-Reykjavik Study, Boston Puerto Rican Health Study, a series of six clinical trials, Framingham Heart Study, Health, Aging, and Body Composition, Invecchiare in Chianti, Osteoporotic Fractures in Men Study, Rancho Bernardo Study, and Study of Osteoporotic Fractures. Feedback from conference attendees was obtained via surveys and breakout groups.
  
  
  RESULTS
  The pooled sample included 26,625 participants (57% women, mean age in men 75.2 [±6.1 SD] and in women 78.6 [±5.9] years). Conference attendees emphasized the importance of evaluating the influence of body mass on cutpoints. Based on the analyses presented in this series, the final recommended cutpoints for weakness are grip strength <26kg for men and <16kg for women, and for low lean mass, appendicular lean mass adjusted for body mass index <0.789 for men and <0.512 for women.
  
  
  CONCLUSIONS
  These evidence-based cutpoints, based on a large and diverse population, may help identify participants for clinical trials and should be evaluated among populations with high rates of functional limitations.
authors.affiliation: Baltimore Longitudinal Study of Aging, National Institute on Aging, 3001 S Hanover Street, Fifth Floor, Baltimore MD 21225. studenskisa@mail.nih.gov.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Studenski
authors.forename: Katherine W
authors.initials: KW
authors.lastname: Peters
authors.forename: Dawn E
authors.initials: DE
authors.lastname: Alley
authors.forename: Peggy M
authors.initials: PM
authors.lastname: Cawthon
authors.forename: Robert R
authors.initials: RR
authors.lastname: McLean
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.forename: Maren S
authors.initials: MS
authors.lastname: Fragala
authors.forename: Anne M
authors.initials: AM
authors.lastname: Kenny
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Kiel
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Kritchevsky
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Shardell
authors.forename: Thuy-Tien L
authors.initials: TT
authors.lastname: Dam
authors.forename: Maria T
authors.initials: MT
authors.lastname: Vassileva
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D004198:Disease Susceptibility; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D009316:National Institutes of Health (U.S.); D012107:Research Design; D012307:Risk Factors; D055948:Sarcopenia / Q000175:diagnosis* / Q000209:etiology; D012737:Sex Factors; D014481:United States
keywords: Aging; Muscle; Outcomes; Sarcopenia; Weakness.
references.citation: J Am Geriatr Soc. 2003 Nov;51(11):1602-9
references.pmid: 14687390
references.citation: Contemp Clin Trials. 2005 Oct;26(5):557-68
references.pmid: 16085466
references.citation: J Gerontol A Biol Sci Med Sci. 2014 May;69(5):584-90
references.pmid: 24737561
references.citation: J Gerontol A Biol Sci Med Sci. 2005 Mar;60(3):324-33
references.pmid: 15860469
references.citation: Epidemiol Rev. 2013;35:51-65
references.pmid: 23221972
references.citation: Age Ageing. 2010 Jul;39(4):412-23
references.pmid: 20392703
references.citation: J Nutr Health Aging. 2013 Jan;17(1):76-80
references.pmid: 23299384
references.citation: JAMA. 2003 May 21;289(19):2560-72
references.pmid: 12748199
references.citation: JAMA. 2005 May 4;293(17):2102-8
references.pmid: 15870413
references.citation: J Nutr Health Aging. 2009 Oct;13(8):708-12
references.pmid: 19657554
references.citation: N Engl J Med. 1995 Mar 23;332(12):767-73
references.pmid: 7862179
references.citation: Contemp Clin Trials. 2005 Oct;26(5):569-85
references.pmid: 16084776
references.citation: J Am Geriatr Soc. 2003 Mar;51(3):323-30
references.pmid: 12588575
references.citation: J Gerontol A Biol Sci Med Sci. 2014 May;69(5):576-83
references.pmid: 24737560
references.citation: J Gerontol A Biol Sci Med Sci. 2001 May;56(5):M266-72
references.pmid: 11320105
references.citation: J Gerontol A Biol Sci Med Sci. 2000 Apr;55(4):M221-31
references.pmid: 10811152
references.citation: Am J Epidemiol. 1979 Sep;110(3):281-90
references.pmid: 474565
references.citation: J Gerontol A Biol Sci Med Sci. 2014 May;69(5):567-75
references.pmid: 24737559
references.citation: Circulation. 2004 Jul 13;110(2):227-39
references.pmid: 15249516
references.citation: J Nutr Health Aging. 2009 Dec;13(10):881-9
references.pmid: 19924348
references.citation: J Am Geriatr Soc. 2010 Sep;58(9):1707-14
references.pmid: 20863330
references.citation: J Gerontol A Biol Sci Med Sci. 2014 May;69(5):559-66
references.pmid: 24737558
references.citation: J Am Geriatr Soc. 2000 Dec;48(12):1618-25
references.pmid: 11129752
references.citation: BMC Public Health. 2010 Mar 01;10:107
references.pmid: 20193082
references.citation: Am J Epidemiol. 1998 Apr 15;147(8):755-63
references.pmid: 9554417
references.citation: J Appl Physiol (1985). 2000 Jul;89(1):345-52
references.pmid: 10904070
references.citation: Clin Geriatr Med. 2011 Aug;27(3):387-99
references.pmid: 21824554
references.citation: J Gerontol A Biol Sci Med Sci. 2006 Jan;61(1):72-7
references.pmid: 16456196
references.citation: Am J Prev Med. 2003 Oct;25(3):226-31
references.pmid: 14507529
references.citation: Am J Epidemiol. 2007 May 1;165(9):1076-87
references.pmid: 17351290
references.citation: JAMA. 2011 Jan 5;305(1):50-8
references.pmid: 21205966
references.citation: JAMA. 2003 Aug 27;290(8):1042-8
references.pmid: 12941676
references.citation: Osteoporos Int. 2005 Sep;16(9):1096-108
references.pmid: 15754082
references.citation: J Hand Surg Br. 1993 Feb;18(1):129-32
references.pmid: 8436850
references.citation: Diabetes Care. 2003 Nov;26(11):3160-7
references.pmid: 14578255
references.citation: Am J Public Health Nations Health. 1951 Mar;41(3):279-81
references.pmid: 14819398
references.citation: J Am Geriatr Soc. 2003 Dec;51(12):1762-7
references.pmid: 14687355
references.citation: J Gerontol A Biol Sci Med Sci. 2008 Aug;63(8):829-34
references.pmid: 18772470
references.citation: J Appl Physiol (1985). 1999 Oct;87(4):1513-20
references.pmid: 10517786
references.citation: J Am Geriatr Soc. 2002 May;50(5):897-904
references.pmid: 12028178