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Cutpoints for Low Appendicular Lean Mass That Identify Older Adults With Clinically Significant Weakness

Identifieur interne : 003582 ( Main/Exploration ); précédent : 003581; suivant : 003583

Cutpoints for Low Appendicular Lean Mass That Identify Older Adults With Clinically Significant Weakness

Auteurs : Peggy M. Cawthon ; Katherine W. Peters ; Michelle D. Shardell ; Robert R. Mclean ; Thuy-Tien L. Dam ; Anne M. Kenny ; Maren S. Fragala ; Tamara B. Harris ; Douglas P. Kiel ; Jack M. Guralnik ; Luigi Ferrucci ; Stephen B. Kritchevsky ; Maria T. Vassileva ; Stephanie A. Studenski ; Dawn E. Alley

Source :

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences [ 1079-5006 ] ; 2014.

RBID : PMC:3991141

Abstract

Background.

Low lean mass is potentially clinically important in older persons, but criteria have not been empirically validated. As part of the FNIH (Foundation for the National Institutes of Health) Sarcopenia Project, this analysis sought to identify cutpoints in lean mass by dual-energy x-ray absorptiometry that discriminate the presence or absence of weakness (defined in a previous report in the series as grip strength <26kg in men and <16kg in women).

Methods.

In pooled cross-sectional data stratified by sex (7,582 men and 3,688 women), classification and regression tree (CART) analysis was used to derive cutpoints for appendicular lean body mass (ALM) that best discriminated the presence or absence of weakness. Mixed-effects logistic regression was used to quantify the strength of the association between lean mass category and weakness.

Results.

In primary analyses, CART models identified cutpoints for low lean mass (ALM <19.75kg in men and <15.02kg in women). Sensitivity analyses using ALM divided by body mass index (BMI: ALM_BMI) identified a secondary definition (ALM_BMI <0.789 in men and ALM_BMI <0.512 in women). As expected, after accounting for study and age, low lean mass (compared with higher lean mass) was associated with weakness by both the primary (men, odds ratio [OR]: 6.9 [95% CI: 5.4, 8.9]; women, OR: 3.6 [95% CI: 2.9, 4.3]) and secondary definitions (men, OR: 4.3 [95% CI: 3.4, 5.5]; women, OR: 2.2 [95% CI: 1.8, 2.8]).

Conclusions.

ALM cutpoints derived from a large, diverse sample of older adults identified lean mass thresholds below which older adults had a higher likelihood of weakness.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991141

DOI: 10.1093/gerona/glu023
PubMed: 24737559
PubMed Central: 3991141

Affiliations:

Le document en format XML

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<affiliation><nlm:aff id="AF0008"><institution>Institute for Aging Research, Hebrew Senior Life Institute for Aging Research,</institution>
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<author><name sortKey="Ferrucci, Luigi" sort="Ferrucci, Luigi" uniqKey="Ferrucci L" first="Luigi" last="Ferrucci">Luigi Ferrucci</name>
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.</nlm:aff>
</affiliation>
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<author><name sortKey="Kritchevsky, Stephen B" sort="Kritchevsky, Stephen B" uniqKey="Kritchevsky S" first="Stephen B." last="Kritchevsky">Stephen B. Kritchevsky</name>
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.</nlm:aff>
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<author><name sortKey="Vassileva, Maria T" sort="Vassileva, Maria T" uniqKey="Vassileva M" first="Maria T." last="Vassileva">Maria T. Vassileva</name>
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,<addr-line>Bethesda, Maryland</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Studenski, Stephanie A" sort="Studenski, Stephanie A" uniqKey="Studenski S" first="Stephanie A." last="Studenski">Stephanie A. Studenski</name>
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,<addr-line>Pennsylvania</addr-line>
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<affiliation><nlm:aff id="AF0012"><institution>VA Pittsburgh Healthcare System</institution>
,<addr-line>Pennsylvania</addr-line>
.</nlm:aff>
</affiliation>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Cutpoints for Low Appendicular Lean Mass That Identify Older Adults With Clinically Significant Weakness</title>
<author><name sortKey="Cawthon, Peggy M" sort="Cawthon, Peggy M" uniqKey="Cawthon P" first="Peggy M." last="Cawthon">Peggy M. Cawthon</name>
<affiliation><nlm:aff id="AF0001"><institution>California Pacific Medical Center Research Institute</institution>
,<addr-line>San Francisco</addr-line>
.</nlm:aff>
</affiliation>
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<author><name sortKey="Peters, Katherine W" sort="Peters, Katherine W" uniqKey="Peters K" first="Katherine W." last="Peters">Katherine W. Peters</name>
<affiliation><nlm:aff id="AF0001"><institution>California Pacific Medical Center Research Institute</institution>
,<addr-line>San Francisco</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Shardell, Michelle D" sort="Shardell, Michelle D" uniqKey="Shardell M" first="Michelle D." last="Shardell">Michelle D. Shardell</name>
<affiliation><nlm:aff id="AF0002"><institution>Department of Epidemiology and Public Health, University of Maryland School of Medicine</institution>
,<addr-line>College Park</addr-line>
.</nlm:aff>
</affiliation>
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<author><name sortKey="Mclean, Robert R" sort="Mclean, Robert R" uniqKey="Mclean R" first="Robert R." last="Mclean">Robert R. Mclean</name>
<affiliation><nlm:aff id="AF0003"><institution>Division of Gerontology, Beth Israel Deaconess Medical Center and Harvard Medical School,</institution>
<addr-line>Boston, Massachusetts.</addr-line>
</nlm:aff>
<wicri:noCountry code="subfield">Massachusetts.</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Dam, Thuy Tien L" sort="Dam, Thuy Tien L" uniqKey="Dam T" first="Thuy-Tien L." last="Dam">Thuy-Tien L. Dam</name>
<affiliation><nlm:aff id="AF0004"><institution>Department of Medicine, Columbia University</institution>
,<addr-line>New York, New York</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kenny, Anne M" sort="Kenny, Anne M" uniqKey="Kenny A" first="Anne M." last="Kenny">Anne M. Kenny</name>
<affiliation><nlm:aff id="AF0005"><institution>Center on Aging, University of Connecticut Health Center</institution>
,<addr-line>Farmington</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fragala, Maren S" sort="Fragala, Maren S" uniqKey="Fragala M" first="Maren S." last="Fragala">Maren S. Fragala</name>
<affiliation><nlm:aff id="AF0005"><institution>Center on Aging, University of Connecticut Health Center</institution>
,<addr-line>Farmington</addr-line>
.</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="AF0006"><institution>University of Central Florida</institution>
,<addr-line>Orlando</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Harris, Tamara B" sort="Harris, Tamara B" uniqKey="Harris T" first="Tamara B." last="Harris">Tamara B. Harris</name>
<affiliation><nlm:aff id="AF0007"><institution>National Institute on Aging</institution>
,<addr-line>Bethesda, Maryland</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kiel, Douglas P" sort="Kiel, Douglas P" uniqKey="Kiel D" first="Douglas P." last="Kiel">Douglas P. Kiel</name>
<affiliation><nlm:aff id="AF0003"><institution>Division of Gerontology, Beth Israel Deaconess Medical Center and Harvard Medical School,</institution>
<addr-line>Boston, Massachusetts.</addr-line>
</nlm:aff>
<wicri:noCountry code="subfield">Massachusetts.</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="AF0008"><institution>Institute for Aging Research, Hebrew Senior Life Institute for Aging Research,</institution>
<addr-line>Boston, Massachusetts.</addr-line>
</nlm:aff>
<wicri:noCountry code="subfield">Massachusetts.</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Guralnik, Jack M" sort="Guralnik, Jack M" uniqKey="Guralnik J" first="Jack M." last="Guralnik">Jack M. Guralnik</name>
<affiliation><nlm:aff id="AF0002"><institution>Department of Epidemiology and Public Health, University of Maryland School of Medicine</institution>
,<addr-line>College Park</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ferrucci, Luigi" sort="Ferrucci, Luigi" uniqKey="Ferrucci L" first="Luigi" last="Ferrucci">Luigi Ferrucci</name>
<affiliation><nlm:aff id="AF0007"><institution>National Institute on Aging</institution>
,<addr-line>Bethesda, Maryland</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kritchevsky, Stephen B" sort="Kritchevsky, Stephen B" uniqKey="Kritchevsky S" first="Stephen B." last="Kritchevsky">Stephen B. Kritchevsky</name>
<affiliation><nlm:aff id="AF0009"><institution>The Sticht Center on Aging and Department of Internal Medicine, Wake Forest University</institution>
,<addr-line>North Carolina</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Vassileva, Maria T" sort="Vassileva, Maria T" uniqKey="Vassileva M" first="Maria T." last="Vassileva">Maria T. Vassileva</name>
<affiliation><nlm:aff id="AF0010"><institution>Foundation for the NIH Biomarkers Consortium</institution>
,<addr-line>Bethesda, Maryland</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Studenski, Stephanie A" sort="Studenski, Stephanie A" uniqKey="Studenski S" first="Stephanie A." last="Studenski">Stephanie A. Studenski</name>
<affiliation><nlm:aff id="AF0011"><institution>Department of Internal Medicine, University of Pittsburgh</institution>
,<addr-line>Pennsylvania</addr-line>
.</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="AF0012"><institution>VA Pittsburgh Healthcare System</institution>
,<addr-line>Pennsylvania</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Alley, Dawn E" sort="Alley, Dawn E" uniqKey="Alley D" first="Dawn E." last="Alley">Dawn E. Alley</name>
<affiliation><nlm:aff id="AF0002"><institution>Department of Epidemiology and Public Health, University of Maryland School of Medicine</institution>
,<addr-line>College Park</addr-line>
.</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">The Journals of Gerontology Series A: Biological Sciences and Medical Sciences</title>
<idno type="ISSN">1079-5006</idno>
<idno type="eISSN">1758-535X</idno>
<imprint><date when="2014">2014</date>
</imprint>
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<front><div type="abstract" xml:lang="en"><sec><title>Background.</title>
<p>Low lean mass is potentially clinically important in older persons, but criteria have not been empirically validated. As part of the FNIH (Foundation for the National Institutes of Health) Sarcopenia Project, this analysis sought to identify cutpoints in lean mass by dual-energy x-ray absorptiometry that discriminate the presence or absence of weakness (defined in a previous report in the series as grip strength <26kg in men and <16kg in women).</p>
</sec>
<sec><title>Methods.</title>
<p>In pooled cross-sectional data stratified by sex (7,582 men and 3,688 women), classification and regression tree (CART) analysis was used to derive cutpoints for appendicular lean body mass (ALM) that best discriminated the presence or absence of weakness. Mixed-effects logistic regression was used to quantify the strength of the association between lean mass category and weakness.</p>
</sec>
<sec><title>Results.</title>
<p>In primary analyses, CART models identified cutpoints for low lean mass (ALM <19.75kg in men and <15.02kg in women). Sensitivity analyses using ALM divided by body mass index (BMI: ALM<sub>BMI</sub>
) identified a secondary definition (ALM<sub>BMI</sub>
 <0.789 in men and ALM<sub>BMI</sub>
 <0.512 in women). As expected, after accounting for study and age, low lean mass (compared with higher lean mass) was associated with weakness by both the primary (men, odds ratio [OR]: 6.9 [95% CI: 5.4, 8.9]; women, OR: 3.6 [95% CI: 2.9, 4.3]) and secondary definitions (men, OR: 4.3 [95% CI: 3.4, 5.5]; women, OR: 2.2 [95% CI: 1.8, 2.8]).</p>
</sec>
<sec><title>Conclusions.</title>
<p>ALM cutpoints derived from a large, diverse sample of older adults identified lean mass thresholds below which older adults had a higher likelihood of weakness.</p>
</sec>
</div>
</front>
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<author><name sortKey="Alley, De" uniqKey="Alley D">DE Alley</name>
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   |texte=   Cutpoints for Low Appendicular Lean Mass That Identify Older Adults With Clinically Significant Weakness
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Cutpoints for Low Appendicular Lean Mass That Identify Older Adults With Clinically Significant Weakness

Cutpoints for Low Appendicular Lean Mass That Identify Older Adults With Clinically Significant Weakness

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