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, preliminary findings, and provided strategic direction to develop an evidence-based definition of sarcopenia.
RESULTS: The SDOC assembled data from 8 Epidemiologic 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/body mass index (BMI) were identified as discriminators of risk for mobility disability (walking speed<0.8 m/sec), while DXA-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 (IADL) 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 BMI - 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, and race, and comorbidities.
|Journal||The journals of gerontology. Series A : Biological sciences and medical sciences|
|Publication status||E-pub ahead of print - 14 Mar 2019|