Strength and Function Response to Clinical Interventions of Older Women Categorized by Weakness and Low Lean Mass Using Classifications From the Foundation for the National Institute of Health Sarcopenia Project

Autor: Maren S. Fragala, Thuy-Tien L. Dam, Vanessa Barber, James O. Judge, Stephanie A. Studenski, Peggy M. Cawthon, Robert R. McLean, Tamara B. Harris, Luigi Ferrucci, Jack M. Guralnik, Douglas P. Kiel, Stephen B. Kritchevsky, Michelle D. Shardell, Maria T. Vassileva, Anne M. Kenny, James Goodwin
Rok vydání: 2014
Předmět:
Zdroj: The Journals of Gerontology: Series A. 70:202-209
ISSN: 1758-535X
1079-5006
DOI: 10.1093/gerona/glu110
Popis: The age-related loss of muscle mass and strength, termed sarcopenia, represents a significant healthcare burden in the United States, reflecting $18.5 billion in costs in 2000 (1). Based on these statistics, reducing the incidence of sarcopenia by 10% nationwide would result in a potential saving of $1.1 billion (1), thus highlighting the importance of establishing proven interventions. To advance research, consensus on the clinical definition of sarcopenia is required. Currently, estimates of sarcopenia prevalence vary widely due to use of multiple parameters to define the condition (2). In 1989, Rosenberg and colleagues (3) first coined the term sarcopenia as “a reduction in muscle mass with aging.” This definition stimulated others to characterize this condition (4,5). In 1998, Baumgartner and colleagues (4) first defined sarcopenia using appendicular skeletal lean mass, measured via dual-energy x-ray absorptiometry, as less than two standard deviations below the mean of a reference group of young persons (4). Yet muscle function and lean mass are not clearly associated, thus recent studies have suggested broader parameters to define sarcopenia (5,6). Weakness is associated with disability and mortality, but the role of muscle mass is less clear (7–9). Several working groups have made recommendations for defining sarcopenia based on review of the literature and expert opinion (5,10). Most recently, the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project used data pooled from numerous large epidemiologic studies and clinical trials to develop data-driven criteria for clinically meaningful weakness and low lean mass based on cut-points for grip strength and dual-energy x-ray absorptiometry-based appendicular lean mass (ALM), respectively (6). In the FNIH Sarcopenia Project, individuals classified as weak had a higher risk for incident mobility disability after 3 years of follow-up (11), yet it is unclear whether these proposed cut-points identify individuals who will benefit from interventions to improve mobility. The FNIH Sarcopenia Project specifically included studies of clinical trials to address this question of whether response to interventions was altered by sarcopenia, as defined by the data-driven cut-points. The current study seeks to determine whether individuals, when categorized by the FNIH parameters for clinically meaningful weakness and low lean mass, respond to interventions for frailty. We used pooled data from four randomized trials of several different frailty interventions to compare the changes in muscle strength and function among groups of older adults defined as weak and having low lean mass according to the FNIH proposed criteria. We hypothesized that participants with weakness, with or without low lean mass, would respond equally well to interventions as those without weakness.
Databáze: OpenAIRE
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