Sarcopenia as a predictor of all-cause mortality among community-dwelling older people: A systematic review and meta-analysis
Abstract
The aim of this systematic review and meta-analysis was to examine the association between sarcopenia and all-cause mortality among community-dwelling older people. A systematic review was performed using three electronic databases (EMBASE, MEDLINE and the Cochrane Library) to identify prospective cohort studies from January 2009 to February 2017 examining sarcopenia as a predictor of all-cause mortality among community-dwelling older people. We conducted a pooled analysis of mortality associated with sarcopenia, and subgroup analyses based on measurements of muscle mass and length of follow-up by employing a random-effects model. Sensitivity analyses were performed evaluate the cause of high heterogeneity. In addition, methodological quality, heterogeneity and publication bias were evaluated. Of 1703 studies identified, 6 studies incorporating 7367 individuals were included in the meta-analysis for all-cause mortality. The pooled hazard ratios (HRs) of all-cause mortality from the combination of included studies suggested participants with sarcopenia had a significantly higher rate of mortality (pooled HR 1.60, 95%CI 1.24-2.06, I 2=27.8%, p=0.216) than participants without sarcopenia. The subgroup analysis for length of follow-up suggested studies with a follow-up period of less than 5 years found a higher risk of all-cause mortality (pooled HR 2.09, 95%CI 1.21-3.60) than studies with a follow-up period of 5 years or more (pooled HR 1.52, 95%CI 1.14-2.01). A subgroup of anthropometric measures was found to identify higher mortality risks (pooled HR 2.26, 95%CI 1.30-3.92) than a subgroup of dual-energy x-ray (DXA) absorptiometry (pooled HR 1.82, 95%CI 1.04-3.18) factors or a subgroup of bioelectrical impedance analysis (BIA) factors (pooled HR 1.31, 95%CI 1.15-1.49). Sarcopenia is a predictor of all-cause mortality among community-dwelling older people. Therefore, it is important to diagnose sarcopenia and to intervene, in order to reduce mortality rates in the elderly.
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Sarcopenia is an age-related muscle disorder associated with increased risk of fall, fracture, and mortality.
“Sarcopenia is an age-related muscle disorder, and is associated with increased risk of fall, fracture, and mortality (8, 9).”
From The role of obesity in sarcopenia and the optimal body composition to prevent against sarcopenia and obesity (2023) · cites this paper as [9]
Muscle disorders are associated with high risk of mortality.
“Since muscle disorders are associated with high risk of mortality, the reservation of muscle mass and strength is important (9).”
From The role of obesity in sarcopenia and the optimal body composition to prevent against sarcopenia and obesity (2023) · cites this paper as [9]
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Evaluating and Treating Frailty in Cardiac Rehabilitation
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Toward the recognition and management of sarcopenia in routine clinical care
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Obesity paradox in older sarcopenic adults ― a delay in aging: A systematic review and meta-analysis
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Malnutrition-sarcopenia syndrome and all-cause mortality in hospitalized older people
Gümüşsoy, M., Atmış, V., Yalçın, A., Bahşi, R., Yiğit, S., Arı, S., Dokuyan, H. C., Gözükara, M. G., & Sılay, K. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.09.036 · Cited by 52 · see citing works
The LACE study group, Achison, M., Adamson, S., Akpan, A., Aspray, T., Avenell, A., Band, M. M., Bashir, T., Burton, L. A., Cvoro, V., et al. (2022) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.12934 · Cited by 51 · see citing works
Wannamethee, S. G., & Atkins, J. L. (2023) · Current Diabetes Reports · doi:10.1007/s11892-023-01522-2 · Cited by 53 · see citing works
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The association between low calf circumference and mortality: a systematic review and meta-analysis
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“6-fold risk of mortality among community-dwelling older adults [40]; similar associations were found among nursing home and hospitalized patients [41].”
BackgroundSarcopenia: Tilting the Balance of Protein Homeostasis
Tan, K. T., Ang, S. T., & Tsai, S. (2019) · PROTEOMICS · doi:10.1002/pmic.201800411 · Cited by 49 · see citing works
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“Recent meta-analyses have found that sarcopenia is associated with negative health outcomes, such as functional decline and mortality.(4,5) In addition, frailty increases the cost”
BackgroundJiang, T., Lin, T., Shu, X., Song, Q., Dai, M., Zhao, Y., Huang, L., Tu, X., & Yue, J. (2022) · Critical Care · doi:10.1186/s13054-022-04015-y · Cited by 48 · see citing works
“7%), which was much higher than that in community-dwelling older adults [42].”
BackgroundAtmış, V., Yalçın, A., Sılay, K., kandil, S. U., Bahşi, R., Turgut, T., Sürmeli, D. M., Öztorun, H. S., Yaman, S., Coşarderelioğlu, Ç., et al. (2019) · Aging Clinical and Experimental Research · doi:10.1007/s40520-019-01277-5 · Cited by 48 · see citing works
“Sarcopenia was found to be a predictor of all-cause mortality among community dwelling older people in a recent meta-analysis [7].”
BackgroundVancampfort, D., Stubbs, B., Firth, J., & Koyanagi, A. (2018) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2018.11.007 · Cited by 47 · see citing works
Shen, Y., Luo, L., Fu, H., Xie, L., Zhang, W., Lü, J., & Yang, M. J. (2022) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.12948 · Cited by 45 · see citing works
Sarcopenia for predicting mortality among elderly nursing home residents
Yang, M. J., Jiang, J., Zeng, Y., & Tang, H. (2019) · Medicine · doi:10.1097/md.0000000000014546 · Cited by 44 · see citing works
“Second, we did not compare SARC-F (and SARC-CalF) with common sarcopenia criteria, such as the EWGSOP[12] or the Asia Working Group for Sarcopenia (AWGS)[9] criteria.”
InfluentialSarcopenia measurement in research and clinical practice
Dent, E., Woo, J., Scott, D. S., & Hoogendijk, E. O. (2021) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2021.06.003 · Cited by 44 · see citing works
Liao, C.-D., Huang, S.-W., Chen, H.-C., Huang, M.-H., Liou, T.-H., & Lin, C.-L. (2024) · Nutrients · doi:10.3390/nu16070941 · Cited by 45 · see citing works
Michaëlsson, K., Baron, J. A., Byberg, L., Höijer, J., Larsson, S. C., Svennblad, B., Melhus, H., Wolk, A., & Lemming, E. W. (2020) · PLoS Medicine · doi:10.1371/journal.pmed.1003331 · Cited by 43 · see citing works
Neuroprotective effects of exercise on the aging human neuromuscular system
Allen, M. D., Dalton, B. H., Gilmore, K. J., McNeil, C. J., Doherty, T. J., Rice, C. L., & Power, G. A. (2021) · Experimental Gerontology · doi:10.1016/j.exger.2021.111465 · Cited by 45 · see citing works
Stuck, A. K., Basile, G., Freystaetter, G., Molino, C. D. G. R. C., Lang, W., & Bischoff-Ferrari, H. A. (2022) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.13161 · Cited by 43 · see citing works
“Other studies investigated predictive ability of sarcopenia for the outcomes of fractures,(11) readmission,(12) and mortality.(13) However, all these studies included original data dating before 2019 and therefore did not investigate the recently published definitions of sarcopenia such as EWGSOP2 (2019), SDOC (2020),…”
BackgroundBarreto, A. P. M. M., Silva, M. I. B., Pontes, K. S. D. S., da Costa, M. S., Rosina, K. T. D. C., Souza, E., Bregman, R., & Klein, M. R. S. T. (2019) · British Journal Of Nutrition · doi:10.1017/s0007114519002459 · Cited by 42 · see citing works
“The agreement, according to κ values, in the diagnosis of sarcopenia, low muscle mass and low muscle strength between (1) EWGSOP and EWGSOP2 criteria was moderate, substantial and moderate, respectively; (2) EWGSOP and FNIH criteria was slight, slight and moderate, respectively; and (3) EWGSOP2 and FNIH criteria was f…”
BackgroundMethodResultInfluentialFrailty and sarcopenia in combination are more predictive of mortality than either condition alone
Thompson, M. Q., Yu, S., Tucker, G. R. R., Adams, R., Cesari, M., Theou, O., & Visvanathan, R. (2020) · Maturitas · doi:10.1016/j.maturitas.2020.11.009 · Cited by 42 · see citing works
Waqas, K., Chen, J., Trajanoska, K., Ikram, M. A., Uitterlinden, A. G., Rivadeneira, F., & Zillikens, M. C. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab632 · Cited by 41 · see citing works
Berretta, M., Quagliariello, V., Bignucolo, A., Facchini, S., Maurea, N., Francia, R. D., Fiorica, F., Sharifi, S., Bressan, S., Richter, S. N., et al. (2022) · Antioxidants · doi:10.3390/antiox11061090 · Cited by 42 · see citing works
Wang, Y., Luo, D., Liu, J., Song, Y., Jiang, B., & Jiang, H. (2023) · PLoS ONE · doi:10.1371/journal.pone.0286745 · Cited by 40 · see citing works
“analysis of the connection between sarcopenia and all-cause mortality risk discovered a decreased all-cause mortality risk in trials lasting five years or more [62].”
BackgroundWitham, M. D., Granic, A., Pearson, E. R., Robinson, S. M., & Sayer, A. A. (2023) · Drugs & Aging · doi:10.1007/s40266-023-01042-4 · Cited by 43 · see citing works
High serum uric acid level is associated with greater handgrip strength in the aged population
Lee, J. J., Hong, Y. S., Park, S., & Kang, K. Y. (2019) · Arthritis Research & Therapy · doi:10.1186/s13075-019-1858-2 · Cited by 40 · see citing works
Zhang, X., Zhang, W.-W., Yu, X., Dou, Q.-L., & Cheng, A. S. K. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2019.12.026 · Cited by 39 · see citing works
Runkel, M., Diallo, T. D., Lang, S. A., Bamberg, F., Benndorf, M., & Fichtner‐Feigl, S. (2021) · World Journal of Surgery · doi:10.1007/s00268-021-06073-9 · Cited by 39 · see citing works
An Innovative AAL System Based on IoT Technologies for Patients with Sarcopenia
Addante, F., Gaetani, F., Patrono, L., Sancarlo, D., Sergi, I., & Vergari, G. (2019) · Sensors · doi:10.3390/s19224951 · Cited by 38 · see citing works
Associations between dietary patterns at age 71 and the prevalence of sarcopenia 16 years later
Karlsson, M., Becker, W., Michaëlsson, K., Cederholm, T., & Sjögren, P. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2019.04.009 · Cited by 37 · see citing works
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“Though most of these studies have indicated sarcopenia adverse effects on mortality in community-dwelling elderly adults (2-7), nursing home residents (8-10), or in hospitalized populations (11-15), a few studies found that sarcopenia was not associated with higher risk of death in patients receiving hemodialysis (16)…”
Effects of aging and lifelong aerobic exercise on basal and exercise-induced inflammation in women
Lavin, K. M., Perkins, R. K., Jemioło, B., Raue, U., Trappe, S. W., & Trappe, T. A. (2020) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00655.2020 · Cited by 36 · see citing works
Leigheb, M., Alessandro de, S. I. R. E., Colangelo, M., Zagaria, D., Grassi, F. A., Rena, O., Conte, P., Neri, P., Carriero, A., Sacchetti, G. M., et al. (2021) · Diagnostics · doi:10.3390/diagnostics11112158 · Cited by 35 · see citing works
“Sarcopenic patients have an increased physical disability and an overall higher rate of mortality among community-dwelling older people [8].”
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Recent Progress in Sarcopenia Research: a Focus on Operationalizing a Definition of Sarcopenia
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Koyanagi, A., Veronese, N., Solmi, M., Oh, H. Y., Shin, J. I., Jacob, L., Yang, L., Haro, J. M., & Smith, L. (2020) · Nutrients · doi:10.3390/nu12030706 · Cited by 34 · see citing works
“Identifying the risk factors for sarcopenia is important as it is associated with a variety of adverse health outcomes such as falls, fractures, dependency, use of hospital services, institutionalization, poor quality of life, as well as higher mortality [7,8].”
BackgroundSarcopenic obesity and its association with respiratory disease incidence and mortality
Petermann-Rocha, F. E., Yang, S., Gray, S. R., Pell, J. P., Celis-Morales, C. A., & Ho, F. K. W. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2020.03.006 · Cited by 33 · see citing works
SeyedAlinaghi, S., Ghayomzadeh, M., Mirzapour, P., Maroufi, S. F., Pashaei, Z., Ali, Z., Tantuoyir, M. M., Aghaie, N., Vahedi, F., Salmani, R., et al. (2023) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.13212 · Cited by 32 · see citing works
Wei, L., Zeng, J., Fan, M., Chen, B., Li, X., Li, Y., & Xu, S. (2023) · Journal of Diabetes · doi:10.1111/1753-0407.13464 · Cited by 33 · see citing works
“44 As the indicators and cutoff points for assessing HGS and physical performance are similar, these two criteria identify different sarcope-nic populations mainly in the different definitions of low SMM.”
MethodGaytán-González, A., Ocampo-Alfaro, M. D. J., Torres-Naranjo, F., Arroniz-Rivera, M., González-Mendoza, R. G., Gil-Barreiro, M., & Lopez-Taylor, J. R. (2020) · Geriatrics · doi:10.3390/geriatrics5010001 · Cited by 32 · see citing works
Sarcopenia increases the risk for mortality in patients who undergo amputation for diabetic foot
Kim, Y. K., Lee, H. S., Ryu, J. J., Lee, H. I., & Seo, S. G. (2018) · Journal of Foot and Ankle Research · doi:10.1186/s13047-018-0274-1 · Cited by 32 · see citing works
“Sarcopenia is an aged related condition that involves multiple risk factors, and is associated with function decline, frailty, and other poor health outcomes [11, 12].”
BackgroundMilk for Skeletal Muscle Health and Sarcopenia in Older Adults: A Narrative Review
Granic, A., Hurst, C., Dismore, L. L., Aspray, T., Stevenson, E., Witham, M. D., Sayer, A. A., & Robinson, S. M. (2020) · Clinical Interventions in Aging · doi:10.2147/cia.s245595 · Cited by 32 · see citing works
Jang, W., & Ryu, H. K. (2020) · 대한지역사회영양학회지 · doi:10.5720/kjcn.2020.25.3.226 · Cited by 30 · see citing works
“근감소증은 전세계적 노인 인구의 4~12%에서 발생하는 것 으로 보고되고 있으며[10], 근감소증으로 인한 보행 및 일 상생활 기능의 저하는 낙상[11], 기능장애[12], 삶의 질 저 하[13], 사망[14]의 위험을 높이며 심혈관질환[15] 및 대 사 장애[16]의 위험을 증가시키는 것으로 알려져 있다.”
Diagnostic dependence of muscle strength measurements and the risk of falls in the elderly
Bobowik, P. Ż., & Wiszomirska, I. (2020) · International Journal of Rehabilitation Research · doi:10.1097/mrr.0000000000000430 · Cited by 30 · see citing works
Sarcopenia Prevalence and Risk Factors among Residents in Aged Care
Darroch, P., O’Brien, W. J., Mazahery, H., & Wham, C. A. (2022) · Nutrients · doi:10.3390/nu14091837 · Cited by 29 · see citing works
“Sarcopenia is associated with an increased risk of falls and fractures [5], hospital admissions [6], pneumonia [7], chronic respiratory diseases [8] and all-cause mortality [9].”
BackgroundClinical practice for sarcopenia in Asia: Online survey by the Asian Working Group for Sarcopenia
Yamada, M., Lee, W., Akishita, M., Yang, M. J., Kang, L., Kim, S. Y., Lim, J.-P., Lim, W. S., Merchant, R. A., Ong, T. I. W., et al. (2023) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2023.105132 · Cited by 29 · see citing works
Yamamoto, S., Matsuzawa, R., Hoshi, K., Suzuki, Y., Harada, M., Watanabe, T., Isobe, Y., Imamura, K., Osada, S., Yoshida, A., et al. (2020) · Journal of Renal Nutrition · doi:10.1053/j.jrn.2020.08.006 · Cited by 29 · see citing works
A more accurate method to estimate muscle mass: A new estimation equation
Shi, S., Chen, W., Jiang, Y., Chen, K., Liao, Y., & Huang, K. (2023) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.13254 · Cited by 28 · see citing works
“proximately 2- to 4-fold in community populations.(1,3,4) Therefore, early diagnosis, assessment and intervention of sarcopenia is crucial.”
BackgroundAkazawa, N., Okawa, N., Kishi, M., Hino, T., Tsuji, R., Tamura, K., & Moriyama, H. (2019) · Nutrition · doi:10.1016/j.nut.2019.110600 · Cited by 28 · see citing works
Creatinine/(cystatin C × body weight) ratio is associated with skeletal muscle mass index
Nishida, K., Hashimoto, Y., Kaji, A., Okamura, T., Sakai, R., Kitagawa, N., Osaka, T., Hamaguchi, M., & Fukui, M. (2020) · Endocrine Journal · doi:10.1507/endocrj.ej19-0542 · Cited by 28 · see citing works
Ultrasound Biomarkers for Sarcopenia: What Can We Tell So Far?
Mombiela, R. M., Vucetic, J., Rossi, F., & Tagliafico, A. S. (2020) · Seminars in Musculoskeletal Radiology · doi:10.1055/s-0039-3402745 · Cited by 29 · see citing works
Calleja, M. A. R., Miquélez, A. A., Díez‐Manglano, J., Gullón, A., Pose, A., Formiga, F., Mostaza, J. M., Cepeda, J. M., & Suárez, C. (2019) · Revista Clínica Española · doi:10.1016/j.rce.2019.04.001 · Cited by 27 · see citing works
Calf muscle pump function as a predictor of all-cause mortality
Halkar, M. G., Medina‐Inojosa, J. R., Liedl, D., Wysokiński, W. E., Houghton, D. E., Wennberg, P. W., Lin, G., Kane, G. C., Fischer, K. M., Rooke, T. W., et al. (2020) · Vascular Medicine · doi:10.1177/1358863x20953212 · Cited by 27 · see citing works
- Authors
- Liu, P., Hao, Q., Hai, S., Wang, H., Cao, L., & Dong, B.
- Affiliations
- Sichuan University (CN)
- Corresponding author
- Dong, Birong
- Venue
- Maturitas
- Publisher
- Elsevier BV
- Published
- 2017-09
- Volume
- 103
- Pages
- 16-22
- ISSN
- 0378-5122 (ISSN-L)
- OpenAlex
- W2607358094
- Cited by
- 331
- References
- 40
- Citations by year
- 2026: 21 · 2025: 39 · 2024: 34 · 2023: 46 · 2022: 46 · 2021: 52 · 2020: 57 · 2019: 23 · 2018: 13
- FWCI
- 3.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Maturitas (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- sarcopenia, all-cause mortality, community-dwelling older adults, mortality prediction, muscle mass, follow-up duration, anthropometric measures, dual-energy X-ray absorptiometry, bioelectrical impedance analysis, aging, mortality risk factors, health care utilization
- MeSH terms
- Aged, Humans, Mortality, Sarcopenia, Independent Living
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