title: Case finding for sarcopenia in geriatric inpatients: performance of bioimpedance analysis in comparison to dual X-ray absorptiometry.
abstract: BACKGROUND
  Sarcopenia is a common geriatric syndrome associated with serious adverse health outcomes. The European Working Group on Sarcopenia in Older People (EWGSOP) suggests different methods for case finding for sarcopenia. However, data comparing the different methodological options are scarce for geriatric inpatients.
  
  
  METHODS
  On the basis of the recommendations of the EWGSOP sixty geriatric inpatients underwent measurement of gait speed, hand grip strength and muscle mass by both, dual X-ray absorptiometry (DXA) and bioimpedance analysis (BIA). By linear regression analysis and Bland-Altman plots muscle mass measurements of DXA and BIA were compared. Outcomes of the DXA- and BIA-based approaches for classifying participants as having normal or reduced muscle mass and sarcopenia according to the EWGSOP case finding algorithm were compared by raw agreement and kappa statistics. Finally, on the hypothetical assumption that the DXA-based approach can be set as reference, the performance of the BIA-based approach is illustrated.
  
  
  RESULTS
  Muscle mass measured by BIA was highly correlated to DXA (r > 0.9), but BIA systematically overestimated muscle mass. The mean difference between DXA and BIA was -1.30 kg (p < 0.001) for appendicular and -2.33 kg (p < 0.001) for total muscle mass. The raw agreement between the DXA- and BIA-based approaches for classifying participants as having normal or reduced muscle mass was at best 80 % depending on the BIA cut-offs used. Functional prescreening according to the sarcopenia case finding algorithm of the EWGSOP reduced the need for muscle mass measurement by 37 %, but only marginally changed the agreement between the DXA- and BIA-based approaches.
  
  
  CONCLUSIONS
  Clinicians should be aware that in geriatric inpatients the BIA-based approaches resulted in highly different subgroups of sarcopenic/non-sarcopenic subjects compared to the DXA-based approach following the EWGSOP case finding algorithm. In this pilot-study the BIA-based approach misclassified nearly 1 out of 6 patients if the DXA-based approach is taken as reference.
authors.affiliation: Department of Geriatric Medicine, Christian-Doppler-Klinik, Paracelsus Medical University Salzburg, Ignaz-Harrer-Straße 79, 5020, Salzburg, Austria. j.reiss@salk.at.
authors.forename: Jens
authors.initials: J
authors.lastname: Reiss
authors.affiliation: Department of Geriatric Medicine, Christian-Doppler-Klinik, Paracelsus Medical University Salzburg, Ignaz-Harrer-Straße 79, 5020, Salzburg, Austria. B.Iglseder@salk.at.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Iglseder
authors.affiliation: Department of Clinical Nutrition, Christian-Doppler-Klinik, Paracelsus Medical University Salzburg, Ignaz-Harrer-Straße 79, 5020, Salzburg, Austria. M.Kreutzer@salk.at.
authors.forename: Martina
authors.initials: M
authors.lastname: Kreutzer
authors.affiliation: Department of Clinical Nutrition, Christian-Doppler-Klinik, Paracelsus Medical University Salzburg, Ignaz-Harrer-Straße 79, 5020, Salzburg, Austria. i.weilbuchner@salk.at.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Weilbuchner
authors.affiliation: Department of Clinical Psychology, Christian-Doppler-Klinik, Paracelsus Medical University Salzburg, Ignaz-Harrer-Straße 79, 5020, Salzburg, Austria. w.treschnitzer@salk.at.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Treschnitzer
authors.affiliation: Department of Endocrinology and Nuclear Medicine, Salzburger Landeskliniken, Paracelsus Medical University Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria. H.Kaessmann@salk.at.
authors.forename: Helmut
authors.initials: H
authors.lastname: Kässmann
authors.affiliation: Department of Endocrinology and Nuclear Medicine, Salzburger Landeskliniken, Paracelsus Medical University Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria. c.pirich@salk.at.
authors.forename: Christian
authors.initials: C
authors.lastname: Pirich
authors.affiliation: Department of Geriatric Medicine, Christian-Doppler-Klinik, Paracelsus Medical University Salzburg, Ignaz-Harrer-Straße 79, 5020, Salzburg, Austria. r.reiter@salk.at.
authors.forename: Raphael
authors.initials: R
authors.lastname: Reiter
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D000369:Aged, 80 and over; D000465:Algorithms; D017097:Electric Impedance; D005260:Female; D005684:Gait / Q000502:physiology*; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D007297:Inpatients; D008297:Male; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010865:Pilot Projects; D015995:Prevalence; D055948:Sarcopenia / Q000175:diagnosis / Q000503:physiopathology*