Predictive value of sarcopenia components for all-cause mortality: findings from population-based cohorts

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2024年6月6日

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Leo D. Westbury,
Nicholas C. Harvey,
Charlotte Beaudart,
Olivier Bruyère,
Jane A. Cauley,
Peggy Cawthon,
Alfonso J. Cruz-Jentoft,
Elizabeth M. Curtis,
Kristine Ensrud,
Roger A. Fielding,
Helena Johansson,
John A. Kanis,
Magnus K. Karlsson,
Nancy E. Lane,
Laetitia Lengelé,
Mattias Lorentzon,
Eugene McCloskey,
Dan Mellström,
Anne B. Newman,
Claes Ohlsson,
Eric Orwoll,
Jean-Yves Reginster,
Eva Ribom,
Björn E. Rosengren,
John T. Schousboe,
Elaine M. Dennison,
Cyrus Cooper

摘要

Background

Low grip strength and gait speed are associated with mortality. However, investigation of the additional mortality risk explained by these measures, over and above other factors, is limited.

Aim

We examined whether grip strength and gait speed improve discriminative capacity for mortality over and above more readily obtainable clinical risk factors.

Methods

Participants from the Health, Aging and Body Composition Study, Osteoporotic Fractures in Men Study, and the Hertfordshire Cohort Study were analysed. Appendicular lean mass (ALM) was ascertained using DXA; muscle strength by grip dynamometry; and usual gait speed over 2.4–6 m. Verified deaths were recorded. Associations between sarcopenia components and mortality were examined using Cox regression with cohort as a random effect; discriminative capacity was assessed using Harrell’s Concordance Index (C-index).

Results

Mean (SD) age of participants (n = 8362) was 73.8(5.1) years; 5231(62.6%) died during a median follow-up time of 13.3 years. Grip strength (hazard ratio (95% CI) per SD decrease: 1.14 (1.10,1.19)) and gait speed (1.21 (1.17,1.26)), but not ALM index (1.01 (0.95,1.06)), were associated with mortality in mutually-adjusted models after accounting for age, sex, BMI, smoking status, alcohol consumption, physical activity, ethnicity, education, history of fractures and falls, femoral neck bone mineral density (BMD), self-rated health, cognitive function and number of comorbidities. However, a model containing only age and sex as exposures gave a C-index (95% CI) of 0.65(0.64,0.66), which only increased to 0.67(0.67,0.68) after inclusion of grip strength and gait speed.

Conclusions

Grip strength and gait speed may generate only modest adjunctive risk information for mortality compared with other more readily obtainable risk factors.