Strong Relation Between Muscle Mass Determined by D3-creatine Dilution, Physical Performance, and Incidence of Falls and Mobility Limitations in a Prospective Cohort of Older Men

Cawthon, Peggy M; Orwoll, Eric S; Peters, Katherine E; Ensrud, Kristine E; Cauley, Jane A; Kado, Deborah M; Stefanick, Marcia L; Shikany, James M; Strotmeyer, Elsa S; Glynn, Nancy W; Caserotti, Paolo; Shankaran, Mahalakshmi; Hellerstein, Marc; Cummings, Steven R; Evans, William J; Osteoporotic Fractures in Men (MrOS) Study Research Group

doi:10.1093/gerona/gly129

Cited by 213Nutrition and Health in AgingBody Composition Measurement TechniquesFrailty in Older Adults

Strong Relation Between Muscle Mass Determined by D3-creatine Dilution, Physical Performance, and Incidence of Falls and Mobility Limitations in a Prospective Cohort of Older Men

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Cawthon, Peggy M, Orwoll, Eric S, Peters, Katherine E, Ensrud, Kristine E, Cauley, Jane A, Kado, Deborah M, Stefanick, Marcia L, Shikany, James M +8 more·2019·The Journals of Gerontology: Series A

DOI 10.1093/gerona/gly129PMC PMC6521914

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Abstract

BACKGROUND: Direct assessment of skeletal muscle mass in older adults is clinically challenging. Relationships between lean mass and late-life outcomes have been inconsistent. The D3-creatine dilution method provides a direct assessment of muscle mass. METHODS: Muscle mass was assessed by D3-creatine (D3Cr) dilution in 1,382 men (mean age, 84.2 years). Participants completed the Short Physical Performance Battery (SPPB); usual walking speed (6 m); and dual x-ray absorptiometry (DXA) lean mass. Men self-reported mobility limitations (difficulty walking 2-3 blocks or climbing 10 steps); recurrent falls (2+); and serious injurious falls in the subsequent year. Across quartiles of D3Cr muscle mass/body mass, multivariate linear models calculated means for SPPB and gait speed; multivariate logistic models calculated odds ratios for incident mobility limitations or falls. RESULTS: Compared to men in the highest quartile, those in the lowest quartile of D3Cr muscle mass/body mass had slower gait speed (Q1: 1.04 vs Q4: 1.17 m/s); lower SPPB (Q1: 8.4 vs Q4: 10.4 points); greater likelihood of incident serious injurious falls (odds ratio [OR] Q1 vs Q4: 2.49, 95% confidence interval [CI]: 1.37, 4.54); prevalent mobility limitation (OR Q1 vs Q4,: 6.1, 95% CI: 3.7, 10.3) and incident mobility limitation (OR Q1 vs Q4: 2.15 95% CI: 1.42, 3.26); p for trend < .001 for all. Results for incident recurrent falls were in the similar direction (p = .156). DXA lean mass had weaker associations with the outcomes. CONCLUSIONS: Unlike DXA lean mass, low D3Cr muscle mass/body mass is strongly related to physical performance, mobility, and incident injurious falls in older men.

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Some studies suggest that the predictive value of lean mass is limited and focus should be on muscle strength and function; others recognize a link between amount of active muscle tissue and adverse outcomes, but this relationship is obscured because lean mass is too confounded and does not accurately measure muscle mass.
“Some studies suggest that the predictive value of lean mass is limited and the focus should be on muscle strength and function instead; whereas others recognize a link between the amount of active muscle tissue and adverse outcomes, but that this relationship is obscured by the fact that lean mass is too confounded and does not accurately measure muscle mass.49,51,53”
From Changes in lean body mass with <scp>glucagon‐like peptide</scp> ‐1‐based therapies and mitigation strategies (2024) · cites this paper as [53]

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Authors: Cawthon, P. M., Orwoll, E. S., Peters, K. E., Ensrud, K. E., Cauley, J. A., Kado, D. M., Stefanick, M. L., Shikany, J. M., Strotmeyer, E. S., Glynn, N. W., Caserotti, P., Shankaran, M., Hellerstein, M., Cummings, S. R., Evans, W. J., & Osteoporotic Fractures in Men (MrOS) Study Research Group
Affiliations: University of California, San Francisco (US)
Oregon Health & Science University (US)
California Pacific Medical Center (US)
University of Minnesota (US)
University of Pittsburgh (US)
University of California San Diego (US)
Stanford University (US)
University of Alabama at Birmingham (US)
University of Southern Denmark (DK)
University of California, Berkeley (US)
Duke University (US)
Corresponding author: Cawthon, Peggy M
Peters, Katherine E
ORCID: Cawthon, Peggy M
Orwoll, Eric S
Ensrud, Kristine E
Cauley, Jane A
Kado, Deborah M
Stefanick, Marcia L
Shikany, James M
Strotmeyer, Elsa S
Glynn, Nancy W
Caserotti, Paolo
Shankaran, Mahalakshmi
Hellerstein, Marc
Cummings, Steven R
Evans, William J
Venue: The Journals of Gerontology: Series A
Publisher: Oxford University Press (OUP)
Published: 2018-06-12
Volume: 74
Issue: 6
Pages: 844-852
ISSN: 1079-5006 (ISSN-L)
1758-535X
DOI: 10.1093/gerona/gly129
PMC: PMC6521914
OpenAlex: W2808132789
Cited by: 213
References: 10
Citations by year: 2026: 13 · 2025: 16 · 2024: 28 · 2023: 38 · 2022: 29 · 2021: 31 · 2020: 34 · 2019: 18 · 2018: 4 · 2012: 1
FWCI: 14.96
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations: The Journals of Gerontology Series A (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, other-oa)
Funders: National Institutes of Health
National Institute on Aging
National Institute of Arthritis and Musculoskeletal and Skin Diseases
National Center for Advancing Translational Sciences
NIH Roadmap for Medical Research (U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, UL1 TR000128)
GlaxoSmithKline
Topics: Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Keywords: skeletal muscle mass, older men, physical performance, walking speed, mobility limitations, falls, injurious falls, lean body mass, dual-energy X-ray absorptiometry, Short Physical Performance Battery, sarcopenia
MeSH terms: Accidental Falls, Walking Speed, Physical Functional Performance, Aged, 80 and over, Creatine, Deuterium, Humans, Indicator Dilution Techniques, Male, Cohort Studies, Absorptiometry, Photon, Body Mass Index, Multivariate Analysis, Muscle, Skeletal, Hand Strength, Mobility Limitation

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Strong Relation Between Muscle Mass Determined by D3-creatine Dilution, Physical Performance, and Incidence of Falls and Mobility Limitations in a Prospective Cohort of Older Men

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