Am J Epidemiol 2004; 159:413-421.
Copyright © 2004 by the Johns
Hopkins Bloomberg School of Public Health
PRACTICE OF EPIDEMIOLOGY |
Skeletal Muscle Cutpoints Associated with Elevated Physical Disability Risk in Older Men and Women
1 Department of Community Health and Epidemiology, Queen’s University, Kingston, Ontario, Canada.
2 Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA.
3 Division of Epidemiology and Preventive Medicine, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM.
4 School of Physical and Health Education, Queen’s University, Kingston, Ontario, Canada.
The purpose of this study was to determine skeletal muscle cutpoints for identifying elevated physical disability risk in older adults. Subjects included 4,449 older (
60 years) participants from the Third National Health and Nutrition Examination Survey during 1988–1994. Physical disability was assessed by questionnaire, and bioimpedance was used to estimate skeletal muscle, which was normalized for height. Receiver operating characteristics were used to develop the skeletal muscle cutpoints associated with a high likelihood of physical disability. Odds for physical disability were compared in subjects whose measures fell above and below these cutpoints. Skeletal muscle cutpoints of 5.76–6.75 and 
5.75 kg/m2 were selected to denote moderate and high physical disability risk in women. The corresponding values in men were 8.51–10.75 and 8.50 kg/m2. Compared with women with low-risk skeletal muscle values, women with moderate- and high-risk skeletal muscle values had odds for physical disability of 1.41 (95% confidence interval (CI): 0.97, 2.04) and 3.31 (95% CI: 1.91, 5.73), respectively. The corresponding odds in men were 3.65 (95% CI: 1.92, 6.94) and 4.71 (95% CI: 2.28, 9.74). This study presents skeletal muscle cutpoints for physical disability risk in older adults. Future applications of these cutpoints include the comparison of morbidity risk in older persons with normal muscle mass and those with sarcopenia, the determination and comparison of sarcopenia prevalences, and the estimation of health-care costs attributable to sarcopenia.
activities of daily living; aging; disability evaluation; men; muscle, skeletal; risk; women
Abbreviations: Abbreviations: CI, confidence interval; Lneg, likelihood ratio for negative result; Lpos, likelihood ratio for positive result; NHANES III, Third National Health and Nutrition Examination Survey; SMI, skeletal muscle index.
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