The Significance of Body Mass Index in Calculating the Cut-Off Points for Low Muscle Mass in the Elderly: Methodological Issues (original) (raw)
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Cut-off points for low skeletal muscle mass in older adults: Colombia versus other populations
F1000Research, 2022
Background: The European Working Group on Sarcopenia in the Elderly defined sarcopenia as a geriatric syndrome with a diagnostic criteria of low skeletal muscle mass (LMM). Various sarcopenia consensuses recommend as cut-offs for LMM, the use of below 2 SDs from the mean skeletal muscle mass index (SMI) of a young reference group. Given the contrast between reported cut-offs, the objective of this study was to establish cut-offs for LMM from older adults in Manizales and compare them with those published in the literature. Methods: This was a prospective, cross-sectional analytical study in 237 healthy elderly patients from the city of Manizales, Colombia. Anthropometric measurements of weight, height and body mass index were estimated. The SMI was estimated with the Xitron Technologies bioimpedance meter using the Janssen formula. For the comparison of SMI cut-offs, studies that evaluated this parameter with bioelectrical impedance analysis (BIA) were taken into account, in additio...
s u m m a r y Background: The reported prevalence of sarcopenia ranges widely depending on its definition criterion. European Working Group on Sarcopenia in Older People (EWGSOP) developed a practical clinical definition and consensus diagnostic criteria. This definition recommends using normative data of the study population rather than other reference populations. Objective: We aimed to define the reference cutoff values for muscle mass, muscle strength and calf circumference in Turkey in order to improve general applicability of EWGSOP criteria. Material and methods: Healthy young adults between 18 and 39 years of age with no known chronic disease or chronic drug usage were included in our study to serve as reference population for assessing muscle mass. Community-dwelling older outpatients were prospectively recruited from the geriatrics outpatient clinics of a university hospital for assessing hand grip strength and calf circumference. Body composition was assessed by bioimpedance analysis. Muscle strength was assessed measuring hand grip strength with a Jamar hand dynamometer. The cutoff thresholds for muscle mass were defined as the mean-2SD of the values of the young reference study population; for grip strength were calculated from ROC analyses using cutoff values that predicted gait speed < 0.8 m/s; and for calf circumference were calculated from ROC analyses using cutoff values that predicted low muscle mass. Results: The young reference group included a total of 301 participants (187 male, 114 female; mean age: 26.5 ± 4.6 years). The cutoff thresholds for skeletal muscle mass indexes were 9.2 kg/m 2 and 7.4 kg/m 2 in males and females, respectively. The older community dwelling group included 406 subjects (123 male, 283 female, mean age: 76.6 ± 6.7 years). The cutoff thresholds for hand grip strength were 32 kg and 22 kg for males and females. The cutoff threshold for calf circumference was 33 cm for both males and females. Conclusions: The cutoff thresholds for muscle mass, grip strength and calf circumference were somewhat higher but comparable with other reference populations. Further worldwide studies from different nations and countries are needed to obtain better reference values.
BMC Musculoskeletal Disorders
Background The reduction of female sex hormones causes changes in the contractile properties of muscles as well as infiltration of fat in the muscle tissue. This results in a consequent decline in muscle strength. These changes are related to higher levels of functional impairment and physical disability. In this sense, several anthropometric indices have been used to quantify body and visceral fat. Thus, the objective of this paper is to propose cutoff points for adiposity anthropometric indices in order to identify low muscle mass, as well as to analyze the relationship between these indices and low muscle mass in middle-aged and older women. Methods Cross-sectional analytical study carried out in the Northeast of Brazil. The sample was formed by 593 women between 40—80 years old. Data collection included anthropometric assessment (BMI: Body Mass Index – WC: Waist Circumference – WHR: Waist-to-hip Ratio – WHtR: Waist-to-height Ratio – CI: Conicity Index – BAI: Body Adiposity Index...
Age and ageing, 2015
there is a lack of consensus on the diagnosis of sarcopenia. A screening and diagnostic algorithm was proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). to assess the performance of the EWGSOP algorithm in determining the proportion of subjects suspected of having sarcopenia and selected to undergo subsequent muscle mass (MM) measurement. a cross-sectional study. the cohorts, Frailty in Brazilian Older People Study-Rio de Janeiro (FIBRA-RJ), Brazil; Coyoacan Cohort (CC), Mexico City, Mexico; and Toledo Study for Healthy Aging (TSHA), Toledo, Spain. three thousand two hundred and sixty community-dwelling individuals, 65 years and older. initially, the EWGSOP algorithm was applied using its originally proposed cut-off values for gait speed and handgrip strength; in the second step, values tailored for the specific cohorts were used. using the originally suggested EWGSOP cut-off points, 83.4% of the total cohort (94.4% in TSHA, 75.5% in FIBRA-RJ, 67.8% in CC...
Journal of the American Geriatrics Society, 2001
OBJECTIVES: To evaluate body composition parameters, including fat-free mass (FFM), appendicular skeletal muscle mass (ASMM), relative skeletal muscle mass (RSM) index, body cell mass (BCM), BCM index, total body potassium (TBK), fat mass, percentage fat mass (FM), and their differences between age groups and to evaluate the frequency of sarcopenia in healthy older subjects DESIGN: Cross-sectional, nonrandomized study. SETTING: Outpatient clinic. PARTICIPANTS: Ninety-one healthy men and 100 healthy women age 60 and older. MEASUREMENTS: FFM, ASMM, FM, and percentage fat mass by whole-body dual-energy x-ray absorptiometry; TBK, BCM, and TBK/FFM ratio by whole body potassium-40 counter. RESULTS: All lean body mass parameters were significantly (P Ͻ .05) lower in subjects age 80 and older than in those age 70 to 79, except ASMM in women. Mean FFM was 4.2 kg (7.3%) lower in men age 80 and older than in those younger than 70 and 2.9 kg (6.8%) lower in women age 80 and older than in those younger than 70. The skeletal muscle mass, reflected by ASMM, decreased more than FFM. This suggests that nonskeletal muscle mass is proportionally preserved during aging. Forty-five percent of men and 30% of women were sarcopenic by definition of BCM index and 11.0% of men and women by definition of RSM index. CONCLUSIONS: Significant age-related differences exist in body composition of older men and women between age 60 and 95. The greater decrease in TBK and BCM than the decrease in FFM and skeletal muscle mass suggests changing composition of FFM with age. Lack of agreement between two independent sarcopenia indexes suggests that further refinement in the definition of a sarcopenia index is necessary.
Assessment and definition of lean body mass deficiency in the elderly
European Journal of Clinical Nutrition, 2014
Although the effect of age on body composition has been intensively discussed during the past 20 years, we do not have a uniform definition of sarcopenia. A suitable definition of low, lean body mass should be based on magnetic resonance imaging (MRI) estimates of muscle mass. Using recent MRI data of a population of 446 healthy free-living Caucasian volunteers (247 females, 199 males) age 18-78 years, a low skeletal muscle mass and sarcopenia were defined as a skeletal muscle mass 41 and 42 s.d. below the mean value obeserved in younger adults at age 18-39 years. The cutoffs for low muscle mass according to the skeletal muscle index (skeletal muscle mass/(height) 2) or the appendicular skeletal muscle mass index (skeletal muscle mass of the limbs/(height) 2) were 6.75 or 4.36 kg/m 2 for females and 8.67 or 5.54 kg/m 2 for males, respectively. On the basis of these cutoffs, prevalences of sarcopenia in the group of adults at 460 years are calculated to be 29% in females and 19.0% in males. Faced with different sarcopenic phenotypes (that is, sarcopenia related to frailty and osteopenia; sarcopenic obesity related to metabolic risks; cachexia related to wasting diseases), future definitions of sarcopenia should be extended to the relations between (i) muscle mass and adipose tissue and (ii) muscle mass and bone mass. Suitable cutoffs should be based on the associations between estimates of body compositions and metabolic risks (for axample, insulin resistance), inflammation and muscle function (that is, muscle strength).
Journal of the American Medical Directors Association, 2015
Sarcopenia is the presence of low muscle mass and poor physical function. We have developed an anthropometric prediction equation (PE). We compared the accuracy of our previously developed anthropometric prediction equation (PE) to dual absorptiometry x-ray (DXA) in predicting low muscle mass and sarcopenia. Cross-sectional study design. Community dwelling. Men and women aged 65 years and older. Gender-specific low muscle mass cutoffs were identified using the lowest 20% of the skeletal muscle index (SMI) where muscle mass was determined using PE in 611 men and 375 women aged 65 years and older. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PE derived low muscle mass were compared with DXA-derived low muscle mass. The cohort was randomized into a development and validation group to identify various cutoffs for low muscle mass via the PE method and test its performance against the DXA method. The PE cutoff for low muscle mass was...
Nutrition Journal, 2013
Objective: This study aimed to examine the cross validity of two anthropometric equations commonly used and propose simple anthropometric equations to estimate appendicular muscle mass (AMM) in elderly women. Methods: Among 234 physically active and functionally independent elderly women, 101 (60 to 89 years) were selected through simple drawing to compose the study sample. The paired t test and the Pearson correlation coefficient were used to perform cross-validation and concordance was verified by intraclass correction coefficient (ICC) and by the Bland and Altman technique. To propose predictive models, multiple linear regression analysis, anthropometric measures of body mass (BM), height, girth, skinfolds, body mass index (BMI) were used, and muscle perimeters were included in the analysis as independent variables. Dual-Energy X-ray Absorptiometry (AMM DXA ) was used as criterion measurement. The sample power calculations were carried out by Post Hoc Compute Achieved Power. Sample power values from 0.88 to 0.91 were observed.
Journal of the American Medical Directors Association, 2013
Background & aims: To establish reference values for limb composition, fat-free mass (FFM) and fat mass (FM) in Italian adults for gender-specific age brackets 20e80 years old and to assess age-related regional changes in body composition. Methods: A multicenter, retrospective study was conducted on 1571 healthy subjects, 1240 women and 331 men. Regional FFM and FM were measured by dual-energy X-ray absorptiometry. FM was expressed as % of limb weight. Results: FFM in men diminished with age in both arms and legs, with reference ranges (25th À75th percentile) of 3.8e4.6 kg and 10.4e12.2 kg, respectively for 20e29 year-olds, and 3.1e3.9 kg and 8.2 e10.4 kg for 70e79 year-olds. Women's arm FFM remained stable with aging (reference values 1.7 e2.2 kg), decreasing in their legs (6.2e7.2 kg for 20e29 year-olds, 5.5e6.5 kg for 70e79 year-olds). Limb FM% increased with age in both genders: the reference values were 9e15% (arms) and 12e21% (legs) for 20e29 year-old men, and 19e26% and 19e29%, respectively, for 70e79 year-olds; for women's arms, they were 25e36% for 20e29 year-olds and 36e48% for 70e79 year-olds, while their leg FM remained the same with aging, i.e. 32e40%. Conclusions: These data complete the published reference values for whole body composition, enabling physiological or pathological changes in limb composition to be identified in Caucasian populations living in the Mediterranean area.
Nutrients, 2020
This study aims to assess the agreement between the appendicular skeletal muscle index (ASMI) and dual-energy X-ray absorptiometry (DXA) using a single frequency bioelectrical impedance analysis (BIA) to assess criteria. Moreover, we used the European working group on sarcopenia in older people 1 (EWGSOP1), EWGSOP2, and the Tengvall equation to estimate a low prevalence in ASMI (under the cutoff criteria). We examined a sample of 765 elderly individuals (27.8% male and 72.2% female, aged 82 ± 8.2 years). Based on the cutoff identified by Tengvall, EWGSOP1, and EWGSOP2, the results showed that the prevalence of low ASMI in females was 10.1%, 11.4%, and 9.2%, respectively, and 98.1%, 30.5%, and 23.5% in males, respectively. Moreover, low ASMI prevalence under each diagnostic criterion and body mass index (BMI) was calculated. For BMI < 25 kg/m2, the ASMI prevalence was 39.9%, 25.9%, and 20.6%, as determined using Tengvall, EWGSOP1, and EWGSOP2, respectively, and for BMI > 25 kg/...