Abstract
OBJECTIVES: To develop an evidence-based definition of sarcopenia that can facilitate identification of older adults at risk for clinically relevant outcomes (eg, self-reported mobility limitation, falls, fractures, and mortality), the Sarcopenia Definition and Outcomes Consortium (SDOC) crafted a set of position statements informed by a literature review and SDOC's analyses of eight epidemiologic studies, six randomized clinical trials, four cohort studies of special populations, and two nationally representative population-based studies. METHODS: Thirteen position statements related to the putative components of a sarcopenia definition, informed by the SDOC analyses and literature synthesis, were reviewed by an independent international expert panel (panel) iteratively and voted on by the panel during the Sarcopenia Position Statement Conference. Four position statements related to grip strength, three to lean mass derived from dual-energy x-ray absorptiometry (DXA), and four to gait speed; two were summary statements. RESULTS: The SDOC analyses identified grip strength, either absolute or scaled to measures of body size, as an important discriminator of slowness. Both low grip strength and low usual gait speed independently predicted falls, self-reported mobility limitation, hip fractures, and mortality in community-dwelling older adults. Lean mass measured by DXA was not associated with incident adverse health-related outcomes in community-dwelling older adults with or without adjustment for body size. CONCLUSION: The panel agreed that both weakness defined by low grip strength and slowness defined by low usual gait speed should be included in the definition of sarcopenia. These position statements offer a rational basis for an evidence-based definition of sarcopenia. The analyses that informed these position statements are summarized in this article and discussed in accompanying articles in this issue of the journal.
| Original language | English |
|---|---|
| Pages (from-to) | 1410-1418 |
| Number of pages | 9 |
| Journal | Journal of the American Geriatrics Society |
| Volume | 68 |
| Issue number | 7 |
| Early online date | 9 Mar 2020 |
| DOIs | |
| Publication status | Published - Jul 2020 |
Funding
Hidenori Arai reported receiving honorariums for lectures from Abbott Japan. Shalender Bhasin reported receiving consulting fees from AbbVie and Opko. He reported receiving grants to his institution from Patient‐Centered Outcomes Research Institute, National Institute on Aging (NIA), National Institute of Child Health and Human Development‐National Center for Medical Rehabilitation Research, National Institute of Nursing Research, Foundation of the National Institutes of Health (FNIH), AbbVie, Abbott, AliveGen, FPT, MIB, and Transition Therapeutics. He reported having equity interest in FPT, LLC. Jane Cauley reported serving as an expert witness for a litigation against testosterone gel for CUD. Peggy Cawthon reported receiving grants to her institution from Abbott and Nestlé. Brian Clark reported receiving consulting fees from GLG and Regeneron. He reported receiving grants to his institution from AEIOU Scientific, American Osteopathic Association, Astellas, Department of Defense Congressionally Directed Medical Research Program, MdDS Balance Disorder Foundation, National Institutes of Health (NIH), Osteopathic Heritage Foundations, Regeneron, and RTI Health Solutions. He reported having equity interest in AEIOU Scientific. Cyrus Cooper reported receiving personal fees from Alliance for Better Health, Amgen, Eli Lilly, GSK, Medtronic, Merck, Novartis, Pfizer, Roche, Servier, Takeda, and UCB. Roger Fielding reported receiving consulting fees from Amazentis, Astellas, GSK, Nestlé, and Regeneron. He reported receiving grants to his institution from Astellas, Axcella Health, Biophytis, and Regeneron. He holds stock in Axcella Health, Biophytis, and Segterra/InsideTracker. He serves on an advisory board for Axcella Health, Biophytis, Cytokinetics, and Segterra/InsideTracker. His contribution was partially supported by the US Department of Agriculture, under agreement no. 58‐1950‐4‐003. Jack Guralnik reported receiving consulting fees from Novartis. He serves on an advisory board for Ammonett, Boehringer‐Ingelheim, Pluristem, and Viking. Doug Kiel reported receiving grants to his institution from Merck Sharp & Dohme and Policy Analysis Inc. He reported receiving royalties from Wolters Kluwer. He reported receiving a stipend as editor of a book on osteoporosis in older adults published by Springer. Jay Magaziner reported receiving consulting fees from Scholar Rock. He serves on an advisory board for the American Orthopedic Association, Ammonett, Novartis, Pluristem, and Viking. He serves on the board of directors of Fragility Fracture Network. Anne Newman reported receiving grants to her institution from the Centers for Disease Control and Prevention, California Pacific Medical Center, Johns Hopkins University, MGH, Multiple Myeloma Research Foundation, National Cancer Institute, NIA, University of Florida, and University of Washington. She serves on an advisory board for the NIH National Advisory Council on Aging. She serves as the medical sciences editor in chief of the . Suzette Pereira is an employee, serves on the advisory board, holds stock, receives grants from Abbott Nutrition, and Abbott Nutrition provided through the FNIH the sarcopenia biomarkers consortium. Daniel Rooks is an employee and holds stock in Novartis Institutes for BioMedical Research. Laura Schaap serves as a member of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis working group on frailty and sarcopenia. She is involved in a project on the assessment of muscle function and physical performance in daily clinical practice. Francesco Landi, Todd Manini, Tom Travison, and Jean Woo declared no conflicts of interest for this article. Journal of Gerontology Everyone who contributed significantly to the work has been listed in the author list. We have obtained written/e-mail consent from all contributors who are not authors and are named in the Acknowledgments section. We thank Lyndon Joseph of the National Institute on Aging (NIA), the project's program officer, for his guidance and oversight of the project. We thank Kevin Wilson and Tom Kelly of Hologic Corporation for their assistance in harmonizing the dual-energy x-ray absorptiometry data. Rosalie Correa-De-Araujo is an employee of the NIA. Her participation in the conference or in the article should not be interpreted as representing the official viewpoint of the US Department of Health and Human Services, the National Institutes of Health, or the NIA, except where noted. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the view of the US Department of Agriculture (USDA). The Sarcopenia Definition and Outcomes Consortium (SDOC) was supported by a cooperative agreement from the National Institute on Aging (1UO1AG051421) and by the Foundation for the National Institutes of Health (FNIH grants BHAS16SARC2 and CAWT16SARC2). The SDOC Consortium Position Statement Conference was supported by a conference grant (1R13AG060712‐01) from the NIA and by the FNIH and the Aging in Motion Coalition. Additional support for the Position Statement Conference was provided by Abbott Nutrition, Astellas Corporation, and Cytokinetics. Shalender Bhasin is partly supported by the Boston Claude D. Pepper Older Americans Independence Center (P30AG31679). Roger A. Fielding's contribution was partially supported by the US Department of Agriculture (USDA), under agreement No. 58‐1950‐4‐003.
| Funders | Funder number |
|---|---|
| Osteopathic Heritage Foundation | |
| Medical Research Council | |
| AbbVie | |
| National Institute of Child Health and Human Development‐National Center for Medical Rehabilitation Research | |
| National Institute of Nursing Research, Foundation of the National Institutes of Health | |
| American Osteopathic Association | |
| National Institutes of Health | |
| Abbott Laboratories | |
| AEIOU | |
| Department of Defense Congressionally Directed Medical Research Program | |
| Astellas Pharma US | |
| U.S. Department of Health and Human Services | |
| MdDS Balance Disorder Foundation | |
| National Institute on Aging | R13AG060712, U01AG051421, R01AG048069 |
| U.S. Department of Agriculture | 58‐1950‐4‐003 |
| Boston Claude D. Pepper Older Americans Independence Center | P30AG31679 |
| Foundation for the National Institutes of Health | BHAS16SARC2, 1R13AG060712‐01, CAWT16SARC2 |
UN SDGs
This output contributes to the following UN Sustainable Development Goals (SDGs)
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SDG 10 Reduced Inequalities
Keywords
- consensus definition of sarcopenia
- grip strength cut points
- lean mass cut points
- mobility disability
- sarcopenia
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