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Bioimpedance analysis and physical functioning as mortality indicators among older sarcopenic people.
Exp Gerontol. 2019 07 15; 122:42-46.EG

Abstract

OBJECTIVES

To assess the prognostic significance of various characteristics and measurements of sarcopenia and physical functioning on all-cause mortality among home-dwelling older people with or at-risk of sarcopenia.

DESIGN

Cross-sectional and longitudinal analyses.

SETTING

Porvoo sarcopenia trial in open care.

PARTICIPANTS

Community-dwelling people aged 75 and older (N = 428, of which 182 were re-examined at one year) with four years of follow-up.

MEASUREMENTS

Body mass index (BMI), physical functioning (physical component of the RAND-36) and physical performance tests (Short Physical Performance Battery (SPPB)), hand grip strength, walking speed, Charlson Comorbity Index, bioimpedance-based surrogates for muscle mass: Single Frequency Skeletal Muscle Index (SF-SMI), and Calf Intracellular Resistance Skeletal Muscle Index (CRi-SMI). Date of death was retrieved from central registers. Survival analyses were performed using Life-Table analyses and Cox models.

RESULTS

Most test variables (except BMI) were associated with four-year mortality in a dose-dependent fashion. After controlling for age, gender and co-morbidity, physical performance and functioning (both SPPB and RAND-36), muscle strength (hand grip strength) and CRi-SMI appeared to be independent mortality risk indicators (p < 0.001) whereas SF-SMI was not. When CRi-SMI values were grouped by gender-specific cut-off points, the probability of surviving for four years decreased by 66% among the older people with low CRi-SMI (HR = 0.34, 95%CI 0.15-0.78, p = 0.011). When low CRi-SMI was further controlled for SPPB, the prognostic significance remained significant (HR = 0.55, 95%CI 0.33-0.92, p = 0.021). After controlling for age, gender, comorbidity, and CRi-SMI, the physical component of the RAND-36 (p = 0.007), SPPB (p < 0,001) and hand grip strength (p = 0.009) remained significant mortality predictors. Twelve-month changes were similarly associated with all-cause mortality during the follow-up period.

CONCLUSION

CRi-SMI, muscle strength, physical performance and physical functioning are each strong independent predictors of all-cause mortality among home-dwelling older people. Compared to these indicators, BMI seemed to be clearly inferior. Of two bioimpedance-based muscle indices, CRi SMI was better predictor of mortality than SF-SMI. In this regard, muscle mass, muscle strength and physical performance are all suitable targets for the prevention of sarcopenia-related over-mortality.

Authors+Show Affiliations

University of Helsinki, Institute of Clinical Medicine, Department of Internal Medicine, Geriatric Unit, POB 20, 00014 University of Helsinki, Finland.University of Helsinki, Institute of Clinical Medicine, Department of General Practice, POB 20, 00014 University of Helsinki, Finland; Helsinki University Hospital, Unit of Primary Health Care, Finland. Electronic address: kaisu.pitkala@helsinki.fi.University of Helsinki, Institute of Clinical Medicine, Department of General Practice, POB 20, 00014 University of Helsinki, Finland; Helsinki University Hospital, Unit of Primary Health Care, Finland.University of Helsinki, Institute of Clinical Medicine, Department of Internal Medicine, Geriatric Unit, POB 20, 00014 University of Helsinki, Finland.University of Helsinki, Institute of Clinical Medicine, Department of Internal Medicine, Geriatric Unit, POB 20, 00014 University of Helsinki, Finland.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31026498

Citation

Björkman, Mikko P., et al. "Bioimpedance Analysis and Physical Functioning as Mortality Indicators Among Older Sarcopenic People." Experimental Gerontology, vol. 122, 2019, pp. 42-46.
Björkman MP, Pitkala KH, Jyväkorpi S, et al. Bioimpedance analysis and physical functioning as mortality indicators among older sarcopenic people. Exp Gerontol. 2019;122:42-46.
Björkman, M. P., Pitkala, K. H., Jyväkorpi, S., Strandberg, T. E., & Tilvis, R. S. (2019). Bioimpedance analysis and physical functioning as mortality indicators among older sarcopenic people. Experimental Gerontology, 122, 42-46. https://doi.org/10.1016/j.exger.2019.04.012
Björkman MP, et al. Bioimpedance Analysis and Physical Functioning as Mortality Indicators Among Older Sarcopenic People. Exp Gerontol. 2019 07 15;122:42-46. PubMed PMID: 31026498.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bioimpedance analysis and physical functioning as mortality indicators among older sarcopenic people. AU - Björkman,Mikko P, AU - Pitkala,Kaisu H, AU - Jyväkorpi,Satu, AU - Strandberg,Timo E, AU - Tilvis,Reijo S, Y1 - 2019/04/24/ PY - 2019/02/06/received PY - 2019/04/19/revised PY - 2019/04/20/accepted PY - 2019/4/27/pubmed PY - 2020/7/24/medline PY - 2019/4/27/entrez KW - Bioimpedance analysis KW - Physical functioning KW - Sarcopenia KW - Survival prognosis SP - 42 EP - 46 JF - Experimental gerontology JO - Exp. Gerontol. VL - 122 N2 - OBJECTIVES: To assess the prognostic significance of various characteristics and measurements of sarcopenia and physical functioning on all-cause mortality among home-dwelling older people with or at-risk of sarcopenia. DESIGN: Cross-sectional and longitudinal analyses. SETTING: Porvoo sarcopenia trial in open care. PARTICIPANTS: Community-dwelling people aged 75 and older (N = 428, of which 182 were re-examined at one year) with four years of follow-up. MEASUREMENTS: Body mass index (BMI), physical functioning (physical component of the RAND-36) and physical performance tests (Short Physical Performance Battery (SPPB)), hand grip strength, walking speed, Charlson Comorbity Index, bioimpedance-based surrogates for muscle mass: Single Frequency Skeletal Muscle Index (SF-SMI), and Calf Intracellular Resistance Skeletal Muscle Index (CRi-SMI). Date of death was retrieved from central registers. Survival analyses were performed using Life-Table analyses and Cox models. RESULTS: Most test variables (except BMI) were associated with four-year mortality in a dose-dependent fashion. After controlling for age, gender and co-morbidity, physical performance and functioning (both SPPB and RAND-36), muscle strength (hand grip strength) and CRi-SMI appeared to be independent mortality risk indicators (p < 0.001) whereas SF-SMI was not. When CRi-SMI values were grouped by gender-specific cut-off points, the probability of surviving for four years decreased by 66% among the older people with low CRi-SMI (HR = 0.34, 95%CI 0.15-0.78, p = 0.011). When low CRi-SMI was further controlled for SPPB, the prognostic significance remained significant (HR = 0.55, 95%CI 0.33-0.92, p = 0.021). After controlling for age, gender, comorbidity, and CRi-SMI, the physical component of the RAND-36 (p = 0.007), SPPB (p < 0,001) and hand grip strength (p = 0.009) remained significant mortality predictors. Twelve-month changes were similarly associated with all-cause mortality during the follow-up period. CONCLUSION: CRi-SMI, muscle strength, physical performance and physical functioning are each strong independent predictors of all-cause mortality among home-dwelling older people. Compared to these indicators, BMI seemed to be clearly inferior. Of two bioimpedance-based muscle indices, CRi SMI was better predictor of mortality than SF-SMI. In this regard, muscle mass, muscle strength and physical performance are all suitable targets for the prevention of sarcopenia-related over-mortality. SN - 1873-6815 UR - https://www.unboundmedicine.com/medline/citation/31026498/Bioimpedance_analysis_and_physical_functioning_as_mortality_indicators_among_older_sarcopenic_people_ DB - PRIME DP - Unbound Medicine ER -