title: Definitions of Sarcopenia: Associations with Previous Falls and Fracture in a Population Sample.
abstract: Sarcopenia is common in later life and may be associated with adverse health outcomes such as disability, falls and fracture. There is no consensus definition for its diagnosis although diagnostic algorithms have been proposed by the European Working Group for Sarcopenia in Older People (EWGSOP), the International Working Group on Sarcopenia (IWGS) and the Foundation for the National Institutes of Health Sarcopenia Project (FNIH). More recently, Binkley and colleagues devised a score-based system for the diagnosis of "dysmobility syndrome" in an attempt to combine adverse musculoskeletal phenotypes, including sarcopenia and osteoporosis, in order to identify older individuals at particular risk. We applied these criteria to participants from the Hertfordshire Cohort Study to define their prevalence in an unselected cohort of UK community-dwelling older adults and assess their relationships with previous falls and fracture. Body composition and areal bone mineral density were measured using dual-energy X-ray absorptiometry, gait speed was determined by a 3-m walk test and grip strength was assessed with a Jamar hand-held dynamometer. Researcher-administered questionnaires were completed detailing falls and fracture history. The prevalence of sarcopenia in this cohort was 3.3, 8.3 and 2.0% using the EWGSOP, IWGS and related definition of FNIH, respectively; 24.8% of individuals had dysmobility syndrome. Individuals with dysmobility reported significantly higher number of falls (last year and since the age of 45 years) (p < 0.01) than those without it, but no increased fracture rate was observed in this group (p = 0.96). Those with sarcopenia as defined by the IWGS reported significantly higher falls in the last year and prevalent fractures (falls in the last year: OR 2.51; CI 1.09-5.81; p = 0.03; fractures OR 2.50; CI 1.05-5.92; p = 0.04) but these significant associations were not seen when the EWGSOP definition was applied. The IWGS definition of sarcopenia appears to be an effective means of identifying individuals at risk of prevalent adverse musculoskeletal events.
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Clynes
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: M H
authors.initials: MH
authors.lastname: Edwards
authors.affiliation: University of Wisconsin Osteoporosis Research Program, Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 2870 University Ave, Suite 100, Madison, WI, 53705, USA.|GRECC, William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI, 53705, USA.
authors.forename: B
authors.initials: B
authors.lastname: Buehring
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.|Victoria University, Wellington, New Zealand.
authors.forename: E M
authors.initials: EM
authors.lastname: Dennison
authors.affiliation: University of Wisconsin Osteoporosis Research Program, Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 2870 University Ave, Suite 100, Madison, WI, 53705, USA.|GRECC, William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI, 53705, USA.
authors.forename: N
authors.initials: N
authors.lastname: Binkley
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. cc@mrc.soton.ac.uk.|NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, OX3 5UG, UK. cc@mrc.soton.ac.uk.|NIHR Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Trust, Southampton General Hospital, Southampton, SO16 6YD, UK. cc@mrc.soton.ac.uk.
authors.forename: C
authors.initials: C
authors.lastname: Cooper
mesh_terms: D015502:Absorptiometry, Photon; D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D015331:Cohort Studies; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology*; D005684:Gait; D018737:Hand Strength; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D015995:Prevalence; D055948:Sarcopenia / Q000175:diagnosis* / Q000453:epidemiology*
keywords: Dysmobility; Epidemiology; Falls; Fractures; Sarcopenia