Bioimpedance analysis and physical functioning as mortality indicators among older sarcopenic people

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Bjorkman , M P , Pitkala , K H , Jyvakorpi , S , Strandberg , T E & Tilvis , R S 2019 , ' Bioimpedance analysis and physical functioning as mortality indicators among older sarcopenic people ' , Experimental Gerontology , vol. 122 , pp. 42-46 . https://doi.org/10.1016/j.exger.2019.04.012

Title: Bioimpedance analysis and physical functioning as mortality indicators among older sarcopenic people
Author: Bjorkman, Mikko P.; Pitkala, Kaisu H.; Jyvakorpi, Satu; Strandberg, Timo E.; Tilvis, Reijo S.
Contributor: University of Helsinki, Department of Medicine
University of Helsinki, Department of General Practice and Primary Health Care
University of Helsinki, Department of General Practice and Primary Health Care
University of Helsinki, Timo Strandberg / Principal Investigator
University of Helsinki, Department of Medicine
Date: 2019-07-15
Language: eng
Number of pages: 5
Belongs to series: Experimental Gerontology
ISSN: 0531-5565
URI: http://hdl.handle.net/10138/308319
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 RAND36), 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 allcause 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.
Subject: Sarcopenia
Bioimpedance analysis
Physical functioning
Survival prognosis
SKELETAL-MUSCLE MASS
BIOELECTRICAL-IMPEDANCE
INDEPENDENT PREDICTOR
BODY-COMPOSITION
WEIGHT-LOSS
OBESITY
SPECTROSCOPY
ASSOCIATION
PERFORMANCE
STRENGTH
3121 General medicine, internal medicine and other clinical medicine
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