title: Association of Low Lean Mass With Frailty and Physical Performance: A Comparison Between Two Operational Definitions of Sarcopenia-Data From the Berlin Aging Study II (BASE-II).
abstract: BACKGROUND
  For prevention and treatment of sarcopenia, defined as a decline in lean mass, reliable diagnostic criteria and cutpoints reflecting a clinically relevant threshold are indispensable. As of yet, various parameters have been proposed but no gold standard exists. The aim of this study was to compare cutpoints of appendicular lean mass related to body mass index (ALMBMI) or height (ALM/height(2)) regarding their association with self-reported physical limitations and frailty status in a sample of community-dwelling older adults.
  
  
  METHODS
  A total of 1,343 participants from the Berlin Aging Study II were included. ALM index was assessed with dual-energy X-ray absorptiometry. Limitations in physical performance were assessed via questionnaire and frailty status was defined according to the Fried criteria.
  
  
  RESULTS
  In a risk factor-adjusted analysis, participants with an ALMBMI below the cutpoints had 1.4-2.8 times higher odds of difficulties in several domains of physical activity (p = .031 to p < .0001) compared with participants with normal ALMBMI. In participants with low ALM/height(2), no associations with physical limitations were found. Moreover, the odds of being prefrail/frail were statistically significant for the low ALMBMI group only (odds ratio = 2.403, 95% confidence interval: 1.671-3.454, p < .0001) and not for the low ALM/height(2) group.
  
  
  CONCLUSIONS
  This study showed striking differences between the two operational criteria ALM/height(2) and ALMBMI concerning their association with physical limitations and prefrailty/frailty. The low ALMBMI cutpoints seem suitable to detect patients at risk for negative outcomes such as frailty who might benefit from interventions targeted at improving lean mass.
authors: Charité Research Group on Geriatrics, Charité-Universitätsmedizin, Berlin, Germany. dominik.spira@charite.de.
authors: Dominik
authors: D
authors: Spira
authors: Charité Research Group on Geriatrics, Charité-Universitätsmedizin, Berlin, Germany.
authors: Nikolaus
authors: N
authors: Buchmann
authors: Charité Research Group on Geriatrics, Charité-Universitätsmedizin, Berlin, Germany.
authors: Jivko
authors: J
authors: Nikolov
authors: Charité Research Group on Geriatrics, Charité-Universitätsmedizin, Berlin, Germany. Charité Institute of Medical and Human Genetics, Charité-Universitätsmedizin, Berlin, Germany.
authors: Ilja
authors: I
authors: Demuth
authors: Charité Research Group on Geriatrics, Charité-Universitätsmedizin, Berlin, Germany.
authors: Elisabeth
authors: E
authors: Steinhagen-Thiessen
authors: Charité Research Group on Geriatrics, Charité-Universitätsmedizin, Berlin, Germany.
authors: Rahel
authors: R
authors: Eckardt
authors: Charité Research Group on Geriatrics, Charité-Universitätsmedizin, Berlin, Germany.
authors: Kristina
authors: K
authors: Norman
mesh_terms: D015502:Absorptiometry, Photon; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D050218:Body Fat Distribution; D001827:Body Height; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D016330:Frail Elderly; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055948:Sarcopenia / Q000453:epidemiology*
keywords: Frailty; Functional performance; Sarcopenia