title: Strength and function response to clinical interventions of older women categorized by weakness and low lean mass using classifications from the Foundation for the National Institute of Health sarcopenia project.
abstract: BACKGROUND
  The Foundation for the National Institutes of Health Sarcopenia Project developed data-driven cut-points for clinically meaningful weakness and low lean body mass. This analysis describes strength and function response to interventions based on these classifications.
  
  
  METHODS
  In data from four intervention studies, 378 postmenopausal women with baseline and 6-month data were evaluated for change in grip strength, appendicular lean mass corrected for body mass index, leg strength and power, and short physical performance battery (SPPB). Clinical interventions included hormones, exercise, and nutritional supplementation. Differences in outcomes were evaluated between (i) those with and without weakness and (ii) those with weakness and low lean mass or with one but not the other. We stratified analyses by slowness (walking speed ≤ 0.8 m/s) and by treatment assignment.
  
  
  RESULTS
  The women (72±7 years; body mass index of 26±5kg/m(2)) were weak (33%), had low lean mass (14%), or both (6%). Those with weakness increased grip strength, lost less leg power, and gained SPPB score (p < .05) compared with nonweak participants. Stratified analyses were similar for grip strength and SPPB. With lean mass in the analysis, individuals with weakness had larger gains in grip strength and SPPB scores regardless of low lean mass (p < .01).
  
  
  CONCLUSIONS
  Older women with clinically meaningful muscle weakness increased grip strength and SPPB, regardless of the presence of low lean mass following treatment with interventions for frailty. Thus, results suggest that muscle weakness, as defined by the Foundation for the National Institutes of Health Sarcopenia Project, appears to be a treatable symptom.
authors.affiliation: University of Central Florida, Orlando.
authors.forename: Maren S
authors.initials: MS
authors.lastname: Fragala
authors.affiliation: Columbia University College of Physicians and Surgeons, New York.
authors.forename: Thuy-Tien L
authors.initials: TT
authors.lastname: Dam
authors.affiliation: University of Connecticut Health Center, Farmington.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Barber
authors.affiliation: University of Connecticut Health Center, Farmington.
authors.forename: James O
authors.initials: JO
authors.lastname: Judge
authors.affiliation: National Institute of Aging, National Institutes of Health, Bethesda, Maryland.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Studenski
authors.affiliation: California Pacific Medical Center Research Institute, San Francisco.
authors.forename: Peggy M
authors.initials: PM
authors.lastname: Cawthon
authors.affiliation: Hebrew Senior Life Institute for Aging Research, Boston, Massachusetts. Harvard Medical School, Boston, Massachusetts.
authors.forename: Robert R
authors.initials: RR
authors.lastname: McLean
authors.affiliation: National Institute of Aging, National Institutes of Health, Bethesda, Maryland.
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.affiliation: National Institute of Aging, National Institutes of Health, Bethesda, Maryland.
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.affiliation: University of Maryland School of Medicine, Baltimore.
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.affiliation: Hebrew Senior Life Institute for Aging Research, Boston, Massachusetts. Harvard Medical School, Boston, Massachusetts.
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Kiel
authors.affiliation: Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Kritchevsky
authors.affiliation: University of Maryland School of Medicine, Baltimore.
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Shardell
authors.affiliation: Foundation for the National Institutes of Health, Bethesda, Maryland.
authors.forename: Maria T
authors.initials: MT
authors.lastname: Vassileva
authors.affiliation: University of Connecticut Health Center, Farmington. kenny@uchc.edu.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Kenny
mesh_terms: D015502:Absorptiometry, Photon; D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000368:Aged; D001823:Body Composition / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D019355:Calcium Citrate / Q000627:therapeutic use; D003687:Dehydroepiandrosterone / Q000627:therapeutic use; D004198:Disease Susceptibility; D004958:Estradiol / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000008:administration & dosage; D005260:Female; D005395:Fish Oils / Q000627:therapeutic use; D005684:Gait / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D018908:Muscle Weakness / Q000503:physiopathology; D009316:National Institutes of Health (U.S.); D017698:Postmenopause / Q000502:physiology; D055070:Resistance Training; D055948:Sarcopenia / Q000503:physiopathology* / Q000628:therapy*; D014481:United States; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D000276:Adjuvants, Immunologic; D050071:Bone Density Conservation Agents; D004967:Estrogens; D005395:Fish Oils; D014807:Vitamin D; D003687:Dehydroepiandrosterone; D004958:Estradiol; D019355:Calcium Citrate
keywords: Clinical trials.; Function; Gait speed; Sarcopenia; Strength