Prevalence of sarcopenia among generally healthy community-dwelling adults in a large multinational European population: Baseline data of the DO-HEALTH trial

Authors: STUCK, ANNA - University Of Zurich; TSAI, LI-TANG - University Of Zurich; FREYSTATTER, GREGOR - University Of Zurich; VELLAS, B - University Of Toulouse; KANIS, JOHN - University Of Sheffield Medical School; RIZZOLI, RENE - Geneva University Hospital; KRESSIG, R - University Of Basel; ARMBRECHT, G - Humboldt University; DA SILVA, JOSE - University Of Coimbra; DAWSON-HUGHES, BESS - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; EGLI, ANDREAS - University Of Zurich; BISCHOFF-FERRARI, HEIKE - University Of Zurich

Submitted to: Journal of Nutrition Health and Aging
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/11/2022
Publication Date: 2/15/2023
Citation: Stuck, A.K., Tsai, L., Freystatter, G., Vellas, B., Kanis, J.A., Rizzoli, R., Kressig, R., Armbrecht, G., da Silva, J.A., Dawson-Hughes, B., Egli, A.A., Bischoff-Ferrari, H.A. 2023. Prevalence of sarcopenia among generally healthy community-dwelling adults in a large multinational European population: Baseline data of the DO-HEALTH trial. Journal of Nutrition Health and Aging. https://doi.org/10.1007/s12603-023-1888-y.
DOI: https://doi.org/10.1007/s12603-023-1888-y

Interpretive Summary: Sarcopenia, or low muscle mass, is a common disease in older adults and it is associated with several adverse outcomes including falls and fractures. While sarcopenia is known to be important, there is still ongoing debate in the research community on the best way to define it. One consideration in choosing a definition that would be accepted globally is the prevalence of the disease by the chosen definition. The aim of the study was to assess the prevalence of sarcopenia by the 12 definitions in current use. This study was carried out in 1495 older adults from 4 countries in Europe who participated in the DO-HEALTH clinical trial. In the trial, participants had repeated measurements of muscle mass and strength. We found that the proportion of study participants who would meet the different definitions of sarcopenia varied widely, from 0.7% to 16.8%. The definitions that included muscle strength in combination with muscle mass generally had lower prevalences than those that included only muscle mass. This information should be useful in the process of achieving a global consensus on the best way to define sarcopenia.

Technical Abstract: Objectives: Multinational prevalence data on sarcopenia among generally healthy older adults is limited. The aim of the study was to assess prevalence of sarcopenia in the DO-HEALTH European trial based on twelve current sarcopenia definitions. Setting and Participants: This is an analysis of the DO-HEALTH study including 1495 of 2157 community-dwelling participants aged 70+ from Germany, France, Portugal, and Switzerland with complete measurements of the sarcopenia toolbox including muscle mass by DXA, grip strength, and gait speed. Measurements: The twelve sarcopenia definitions applied were Baumgartner, Delmonico, Foundation for the National Institutes of Health (FNIH1), Asian Working Group on Sarcopenia (AWGS1, AWGS2), European Working Group on Sarcopenia in Older People (EWGSOP1), EWGSOP2, EWGSOP2-lower extremities, FNIH2, Morley, International Working Group on Sarcopenia in Older People (IWGS); and Sarcopenia Definitions and Outcomes Consortium (SDOC). Results: Mean age was 74.9 years (SD 4.4); 63.3% were women. Sarcopenia prevalence ranged between 0.7% using the EWGSOP2 or AWGS2 definition, up to 16.8% using the Delmonico definition. Overall, most sarcopenia definitions, including Delmonico (16.8%), Baumgartner (12.8%), FNIH1(10.5%), IWGS (3.6%), EWGSOP1 (3.4%), SDOC (2.0%), Morley (1.3%), and AWGS1 (1.1%) tended to be higher than the prevalence based on EWGSOP2 (0.7%). In contrast, the definitions AWGS2 (0.7%), EWGSOP2-LE (1.1%), FNIH2 (1.0%) - all based on muscle mass and muscle strength - showed similar lower prevalence as EWGSOP2 (0.7%). Conclusion: In this multinational European trial of generally healthy community-dwelling older adults age 70 years and older sarcopenia prevalence varied widely depending on the sarcopenia definition (components and corresponding cut-off values). There was a pattern suggesting that definitions combining low function with low muscle mass define lower prevalence.