Predictive Values of the New Sarcopenia Index by the Foundation for the National Institutes of Health Sarcopenia Project for Mortality among Older Korean Adults.
OBJECTIVE
We evaluated the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project's recommended criteria for sarcopenia's association with mortality among older Korean adults.


METHODS
We conducted a community-based prospective cohort study which included 560 (285 men and 275 women) older Korean adults aged ≥65 years. Muscle mass (appendicular skeletal muscle mass-to-body mass index ratio (ASM/BMI)), handgrip strength, and walking velocity were evaluated in association with all-cause mortality during 6-year follow-up. Both the lowest quintile for each parameter (ethnic-specific cutoff) and FNIH-recommended values were used as cutoffs.


RESULTS
Forty men (14.0%) and 21 women (7.6%) died during 6-year follow-up. The deceased subjects were older and had lower ASM, handgrip strength, and walking velocity. Sarcopenia defined by both low lean mass and weakness had a 4.13 (95% CI, 1.69-10.11) times higher risk of death, and sarcopenia defined by a combination of low lean mass, weakness, and slowness had a 9.56 (3.16-28.90) times higher risk of death after adjusting for covariates in men. However, these significant associations were not observed in women. In terms of cutoffs of each parameter, using the lowest quintile showed better predictive values in mortality than using the FNIH-recommended values. Moreover, new muscle mass index, ASM/BMI, provided better prognostic values than ASM/height2 in all associations.


CONCLUSIONS
New sarcopenia definition by FNIH was better able to predict 6-year mortality among Korean men. Moreover, ethnic-specific cutoffs, the lowest quintile for each parameter, predicted the higher risk of mortality than the FNIH-recommended values.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.|Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Joon Ho
JH
Moon
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.|Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Kyoung Min
KM
Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.|Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Jung Hee
JH
Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.|Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Jae Hoon
JH
Moon
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.|Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Sung Hee
SH
Choi
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.|Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Soo
S
Lim
Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Jae-Young
JY
Lim
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.
Ki Woong
KW
Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.|Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Kyong Soo
KS
Park
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.|Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Hak Chul
HC
Jang
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D044466:Asian People; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D053580:Muscle Strength; D009132:Muscles / Q000473:pathology; D009316:National Institutes of Health (U.S.); D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D055948:Sarcopenia / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D014481:United States; D016138:Walking