Frailty Status Can Predict Further Lean Body Mass Decline in Older Adults

ObjectivesTo assess whether frailty is a risk factor for skeletal muscle mass decline in community-dwelling elderly people. DesignProspective observational cohort study. SettingSeongnam, Gyeongi Province, Korea. ParticipantsCommunity-dwelling Koreans aged 65 and older (n=341). MeasurementsBioimpedance analysis (BIA) was used to measure body composition at baseline and 5years later. Laboratory examination and comprehensive geriatric assessment were performed at both times. Lean mass index (LMI) was defined as total body lean mass/height(2). A decrease of more than 5% in the LMI was considered to be significant. Frailty status was defined using the Cardiovascular Health Study criteria. ResultsLMI decline occurred in 196 (54.1%) subjects during the follow-up period (5.00.7years). Baseline LMI was highest in robust (17.6 +/- 1.8kg/m(2), n=126), lower prefrail (17.0 +/- 1.7kg/m(2), n=185), and lowest in frail (16.7 +/- 1.3kg/m(2), n=30) subjects (P<.001). Frailty status was associated with LMI decline at 5-year follow-up (robust 0.81 +/- 0.78kg/m(2), prefrail 1.00 +/- 0.92kg/m(2), frail 1.35 +/- 0.85kg/m(2), P<.001). This effect of frailty on LMI decline persisted after adjusting for covariables (P=.02). The risk of significant LMI decline was 2.9 times as great in frail elderly adults as in those who were robust even after adjusting for covariates (95% confidence interval=1.01-8.55). ConclusionFrailty status was found to be independently associated with subsequent LMI decline in community-dwelling older adults.