The Association between Parameters of Malnutrition and Diagnostic Measures of Sarcopenia in Geriatric Outpatients.
OBJECTIVE
Diagnostic criteria for sarcopenia include measures of muscle mass, muscle strength and physical performance. Consensus on the definition of sarcopenia has not been reached yet. To improve insight into the most clinically valid definition of sarcopenia, this study aimed to compare the association between parameters of malnutrition, as a risk factor in sarcopenia, and diagnostic measures of sarcopenia in geriatric outpatients.


METHODS
This study is based on data from a cross-sectional study conducted in a geriatric outpatient clinic including 185 geriatric outpatients (mean age 82 years). Parameters of malnutrition included risk of malnutrition (assessed by the Short Nutritional Assessment Questionnaire), loss of appetite, unintentional weight loss and underweight (body mass index <22 kg/m2). Diagnostic measures of sarcopenia included relative muscle mass (lean mass and appendicular lean mass [ALM] as percentages), absolute muscle mass (total lean mass and ALM/height2), handgrip strength and walking speed. All diagnostic measures of sarcopenia were standardized. Associations between parameters of malnutrition (independent variables) and diagnostic measures of sarcopenia (dependent variables) were analysed using multivariate linear regression models adjusted for age, body mass, fat mass and height in separate models.


RESULTS
None of the parameters of malnutrition was consistently associated with diagnostic measures of sarcopenia. The strongest associations were found for both relative and absolute muscle mass; less stronger associations were found for muscle strength and physical performance. Underweight (p = <0.001) and unintentional weight loss (p = 0.031) were most strongly associated with higher lean mass percentage after adjusting for age. Loss of appetite (p = 0.003) and underweight (p = 0.021) were most strongly associated with lower total lean mass after adjusting for age and fat mass.


CONCLUSIONS
Parameters of malnutrition relate differently to diagnostic measures of sarcopenia in geriatric outpatients. The association between parameters of malnutrition and diagnostic measures of sarcopenia was strongest for both relative and absolute muscle mass, while less strong associations were found with muscle strength and physical performance.
Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam, The Netherlands.
Esmee M
EM
Reijnierse
Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam, The Netherlands; Department of Internal Medicine, Amstelland Hospital, Amstelveen, The Netherlands.
Marijke C
MC
Trappenburg
Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam, The Netherlands.
Morena J
MJ
Leter
Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands; Department of Geriatrics, Bronovo Hospital, The Hague, The Netherlands.
Gerard Jan
GJ
Blauw
Department of Internal Medicine, Section Nutrition and Dietetics, VU University Medical Center, Amsterdam, The Netherlands; Department of Nutrition, Sports and Health, Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands.
Marian A E
MA
de van der Schueren
Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.
Carel G M
CG
Meskers
Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam, The Netherlands.
Andrea B
AB
Maier
D000369:Aged, 80 and over; D001066:Appetite; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications*; D053580:Muscle Strength; D009132:Muscles / Q000473:pathology / Q000503:physiopathology; D009929:Organ Size; D010045:Outpatients; D055948:Sarcopenia / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D015431:Weight Loss