Establishing the link between lean mass and grip strength cut points with mobility disability and other health outcomes: proceedings of the sarcopenia definition and outcomes consortium conference
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BACKGROUND: Lack of consensus on how to diagnose sarcopenia has limited the ability to diagnose this condition and hindered drug development. The Sarcopenia Definitions and Outcomes Consortium (SDOC) was formed to develop evidence-based diagnostic cut points for lean mass and/or muscle strength that identify people at increased risk of mobility disability. We describe here the proceedings of a meeting of SDOC and other experts to discuss strategic considerations in the development of evidence-based sarcopenia definition. METHODS: Presentations and panel discussions reviewed the usefulness of sarcopenia as a biomarker, the analytical approach used by SDOC to establish cut points, and preliminary findings, and provided strategic direction to develop an evidence-based definition of sarcopenia. RESULTS: The SDOC assembled data from eight epidemiological cohorts consisting of 18,831 participants, clinical populations from 10 randomized trials and observational studies, and 2 nationally representative cohorts. In preliminary assessments, grip strength or grip strength divided by body mass index was identified as discriminators of risk for mobility disability (walking speed <0.8 m/s), whereas dual-energy X-ray absorptiometry-derived lean mass measures were not good discriminators of mobility disability. Candidate definitions based on grip strength variables were associated with increased risk of mortality, falls, mobility disability, and instrumental activities of daily living disability. The prevalence of low grip strength increased with age. The attendees recommended the establishment of an International Expert Panel to review a series of position statements on sarcopenia definition that are informed by the findings of the SDOC analyses and synthesis of literature. CONCLUSIONS: International consensus on an evidence-based definition of sarcopenia is needed. Grip strength-absolute or adjusted for body mass index-is an important discriminator of mobility disability and other endpoints. Additional research is needed to develop a predictive risk model that takes into account sarcopenia components as well as age, sex, race, and comorbidities.
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Skeletal muscle mass estimated using BIA and DXA (which do not directly assess muscle) is not a good indicator of functional impairment.
“Skeletal muscle mass, estimated using techniques available for clinical practice such as BIA and DXA that do not directly assess muscle, is not a good indicator of functional impairment [104].”
From Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement (2022) · cites this paper as [104]
The Recommendations section (page unavailable) says DXA-measured lean mass is not a good discriminator of mobility disability, and the Synthesis section reports similar findings for older adults. The paper does not establish the same finding for BIA or functional impairment generally, and the cited passages do not say that these techniques fail to assess muscle directly. (LLM, conf=0.88)
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Self-citationNew insights into the diagnosis and management of bone health in premature ovarian insufficiency
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Frailty and Aging in HIV— Status Post 13 Years of National Awareness
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Validity and Reliability of 3-D Ultrasound Imaging to Measure Hamstring Muscle and Tendon Volumes
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Self-citationOverweight, Obesity, and Late-Life Sarcopenia Among Men With Cardiovascular Disease, Israel
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Role of irisin and myostatin on sarcopenia in malnourished patients diagnosed with GLIM criteria.
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Musculoskeletal Health in Premature Ovarian Insufficiency. Part One: Muscle
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Self-citationAssociation between Circulating Osteoprogenitor Cells and Sarcopenia
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Ultrasonography for Assessment of Sarcopenia
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What Is ‘Muscle Health’? A Narrative Review and Conceptual Framework
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Assessing the impact of sarcopenia on balance in the elderly: an analysis using a force platform
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Dose–Response Associations of Grip Strength and Gait Speed With Multidimensional Mental Health
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Development and validation of a sarcopenia risk prediction model for community-dwelling older adults
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Self-citationThe Role of Different Weakness Cut-Points for Future Cognitive Impairment in Older Americans
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Causal influence of muscle weakness on cardiometabolic diseases and osteoporosis
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- Authors
- Cawthon, P. M., Travison, T. G., Manini, T. M., Patel, S., Pencina, K. M., Fielding, R. A., Magaziner, J. M., Newman, A. B., Brown, T., Kiel, D. P., Cummings, S. R., Shardell, M., Guralnik, J. M., Woodhouse, L. J., Pahor, M., Binder, E., D’Agostino, R. B., Quian-Li, X., Orwoll, E., Landi, F., Orwig, D., Schaap, L., Latham, N. K., Hirani, V., Kwok, T., Pereira, S. L., Rooks, D., Kashiwa, M., Torres-Gonzalez, M., Menetski, J. P., Correa-De-Araujo, R., & Bhasin, S.
- Affiliations
- California Pacific Medical Center (US)
- Beth Israel Deaconess Medical Center (US)
- University of Florida (US)
- Brigham and Women's Hospital (US)
- Tufts University (US)
- University of Maryland, Baltimore (US)
- University of Pittsburgh (US)
- Johns Hopkins University (US)
- National Institute on Aging (US)
- University of Alberta (CA)
- Washington University in St. Louis (US)
- Boston University (US)
- Oregon Health & Science University (US)
- Università Cattolica del Sacro Cuore (IT)
- Vrije Universiteit Amsterdam (NL)
- The University of Sydney (AU)
- Chinese University of Hong Kong (HK)
- Abbott (United States) (US)
- Novartis Biomedical Research Institute, Cambridge, Massachusetts
- Astellas Pharma (Japan) (JP)
- National Dairy Council, Rosemont, Illinois
- Foundation for the National Institutes of Health (US)
- The National Institute on Aging, Bethesda, Maryland
- Corresponding author
- Bhasin, Shalender
- ORCID
- Cawthon, Peggy M
- Travison, Thomas G
- Manini, Todd M
- Pencina, Karol M
- Fielding, Roger A
- Newman, Anne B
- Brown, Todd
- Kiel, Douglas P
- Shardell, Michelle
- Guralnik, Jack M
- Woodhouse, Linda J
- Binder, Ellen
- D’Agostino, Ralph B
- Orwoll, Eric
- Landi, Francesco
- Orwig, Denise
- Schaap, Laura
- Latham, Nancy K
- Hirani, Vasant
- Kwok, Timothy
- Pereira, Suzette L
- Rooks, Daniel
- Menetski, Joseph P
- Bhasin, Shalender
- Venue
- The Journals of Gerontology Series A
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-04-13
- Volume
- 75
- Issue
- 7
- Pages
- 1317-1323
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- PMC
- PMC7447857
- OpenAlex
- W2920920502
- Cited by
- 127
- References
- 42
- Citations by year
- 2026: 4 · 2025: 16 · 2024: 10 · 2023: 12 · 2022: 15 · 2021: 27 · 2020: 30 · 2019: 11 · 2012: 2
- FWCI
- 14.23
- 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)
- VU Research Portal (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- National Institute on Aging (1UO1AG051421, R01 AG005407, R01 AR35582, R01 AR35583, R01 AR35584, R01 AG005394, R01 AG027574, R01 AG027576, N01AG62101, N01AG62103, N01AG62106, R01 AR 41398, U24AG051129, R01AR057118)
- National Institutes of Health (AR066160UL1, TR000128, AR049439-01A1)
- Chinese University of Hong Kong (2041657)
- Swedish Research Council (2006-3832)
- National Heart, Lung, and Blood Institute (N01-HC-25195, N01-HC-85079, N01-HC-85080, N01-HC-85081, N01-HC-85082, N01-HC-85083, N01-HC-85084, N01-HC-85085, N01-HC-85086, N01-HC-35129, N01 HC-15103, N01 HC-55222, N01-HC-75150, N01-HC-45133, N01-HC-85239, HHSN268201200036C, HL080295, HL087652, HL105756, HL103612)
- National Institute of Neurological Disorders and Stroke (AG-023629, AG-15928, AG-20098, AG-027058)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases
- The Johnston County Osteoarthritis Project (S043, S1734, S3486)
- Centers for Disease Control and Prevention (5-P60-AR30701)
- NIAMS Multidisciplinary Clinical Research Center (5 P60 AR49465-03)
- National Health and Medical Research Council (301916)
- Netherlands Organization for Scientific Research (480-10-014)
- 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, sarcopenia definitions, diagnostic thresholds, grip strength, lean body mass, mobility impairment, walking speed, mortality, falls, instrumental activities of daily living, body mass index, risk prediction model, expert panel consensus
- MeSH terms
- Activities of Daily Living, Aged, Body Composition, Disability Evaluation, Female, Humans, Male, Body Mass Index, Hand Strength, Evidence-Based Medicine, Consensus, Mobility Limitation, Sarcopenia
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