Sarcopenia Defined by Combining Height- and Weight-Adjusted Skeletal Muscle Indices is Closely Associated With Poor Physical Performance

Objectives: To compare muscle strength and physical performance among subjects with and without sarcopenia of different definitions. Design: A population-based cross-sectional study. Participants: 857 community residents aged 65 years or older. Methods: Sarcopenia was defined according to the European Working Group of Sarcopenia in Older People consensus criteria. Dual-energy X-ray absorptiometry measured lean soft tissue mass. Sarcopenic participants with low height-adjusted or weight-adjusted skeletal muscle index (SMI) were classified as having h-sarcopenia or w-sarcopenia, respectively. Combined sarcopenia (c-sarcopenia) was defined as having either h- or w-sarcopenia. The participants underwent six physical performance tests: walking speed, timed up-and-go, six-minute walk, single-leg stance, timed chair stands, and flexibility test. The strength of five muscle groups was measured. Results: Participants with h-sarcopenia had lower weight, body mass index (BMI), fat mass, and absolute muscle strength (p <= .001); those with w-sarcopenia had higher weight, BMI, fat mass (p < .001), and low relative muscle strength (p <= .003). Participants with c-sarcopenia had poorer performance in all physical performance tests, whereas h-sarcopenia and w-sarcopenia were associated with poor performance in four tests. Conclusion: Subjects with h- and w-sarcopenia differ significantly in terms of obesity indicators. Combining height- and weight-adjusted SMIs can be a feasible method to define sarcopenia.