期刊
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
卷 63, 期 11, 页码 2247-2259出版社
WILEY
DOI: 10.1111/jgs.13788
关键词
sarcopenia; falls; fractures; mortality; functional limitation
资金
- 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]
- VA Clinical Science Research and Development Career Development Award [5IK2CW000729-02]
ObjectiveTo evaluate the associations between definitions of sarcopenia and clinical outcomes and the ability of the definitions to discriminate those with a high likelihood of having these outcomes from those with a low likelihood. DesignOsteoporotic Fractures in Men Study. SettingSix clinical centers. ParticipantsCommunity-dwelling men aged 65 and older (N = 5,934). MeasurementsSarcopenia definitions from the International Working Group, European Working Group on Sarcopenia in Older Persons, Foundation for the National Institutes of Health Sarcopenia Project, Baumgartner, and Newman were evaluated. Recurrent falls were defined as two or more self-reported falls in the year after baseline (n = 694, 11.9%). Incident hip fractures (n = 207, 3.5%) and deaths (n = 2,003, 34.1%) were confirmed according to central review of medical records over 9.8 years. Self-reported functional limitations were assessed at baseline and 4.6 years later. Logistic regression or proportional hazards models were used to estimate associations between sarcopenia and falls, hip fractures, and death. The discriminative ability of the sarcopenia definitions (vs reference models) for these outcomes was evaluated using area under the receiver operating characteristic curve or C-statistics. Referent models included age alone for falls, functional limitations and mortality, and age and bone mineral density for hip fractures. ResultsThe association between sarcopenia according to the various definitions and risk of falls, functional limitations, and hip fractures was variable; all definitions were associated with greater risk of death, but none of the definitions materially changed discrimination based on the AUC and C-statistic when compared with reference models (change 1% in all models). ConclusionSarcopenia definitions as currently constructed did not consistently improve prediction of clinical outcomes in relatively healthy older men.
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