Sarcopenia-related parameters and incident disability in older persons: results from the "invecchiare in Chianti" study

J Gerontol A Biol Sci Med Sci. 2015 Apr;70(4):457-63. doi: 10.1093/gerona/glu181. Epub 2014 Oct 15.


Background: Current operational definitions of sarcopenia are based on algorithms' simultaneous considering measures of skeletal muscle mass and muscle-specific as well as global function. We hypothesize that quantitative and qualitative sarcopenia-related parameters may not be equally predictive of incident disability, thus presenting different clinical relevance.

Methods: Data are from 922 elder adults (mean age = 73.9 years) with no activities of daily living (ADL) impairment recruited in the "Invecchiare in Chianti" study. Incident disability in ≥1 ADL defined the outcome of interest. The specific capacities of following sarcopenia-related parameters at predicting incident ADL disability were compared: residuals of skeletal muscle mass, fat-adjusted residuals of skeletal muscle mass, muscle density, ankle extension strength, ratio ankle extension strength/muscle mass, gait speed, and handgrip strength.

Results: During the follow-up (median = 9.1 years), 188 (20.4%) incident ADL disability events were reported. Adjusted models showed that only gait speed was significantly associated with the outcome in both men (per standard deviation [SD] = 0.23 m/s increase, hazard ratio [HR] = 0.46, 95% confidence interval [CI] = 0.33-0.63; p < .001) and women (per SD = 0.24 m/s increase, HR = 0.64, 95% CI = 0.50-0.82; p < .001). In women, the fat-adjusted lean mass residual (per SD = 4.41 increase, HR = 0.79, 95% CI = 0.65-0.96; p = .02) and muscle density (per SD = 3.60 increase, HR = 0.76, 95% CI = 0.61-0.93; p = .01) were the only other parameters that predicted disability. In men, several of the tested variables (except muscle mass measures) reported significant results.

Conclusions: Gender strongly influences which sarcopenia-related parameters predict disability. Gait speed was a powerful predictor of disability in both men and women, but its nonmuscle-specific nature should impose caution about its inclusion in definitions of sarcopenia.

Keywords: Body composition; Disability; Gait speed.; Sarcopenia; Skeletal muscle.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aging*
  • Body Mass Index
  • Disabled Persons / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Gait*
  • Geriatric Assessment* / methods
  • Hand Strength
  • Humans
  • Incidence
  • Italy / epidemiology
  • Male
  • Muscle Strength*
  • Predictive Value of Tests
  • Prevalence
  • Research Design
  • Risk Factors
  • Sarcopenia / diagnosis*
  • Sarcopenia / epidemiology
  • Sarcopenia / physiopathology
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Sex Distribution