Identification of Sarcopenia Components That Discriminate Slow Walking Speed: A Pooled Data Analysis

作者：Todd M. Manini, Sheena Patel, Anne B. Newman, Thomas G. Travison, Douglas P. Kiel, Michelle Shardell, Karol M. Pencina, Kevin E. Wilson, Thomas L. Kelly, Joseph M. Massaro, Roger A. Fielding, Jay Magaziner, Rosaly Correa‐de‐Araujo, Timothy Kwok, Vasant Hirani, Magnus K. Karlsson, Ralph B. D’Agostino, Dan Mellström, Claes Ohlsson, Eva Ribom, Joanne M. Jordan, Shalender Bhasin, Peggy M. Cawthon · 发表于：Journal of the American Geriatrics Society · 年份：2020 · DOI：10.1111/jgs.16524 · 被引用次数：62 · 研究领域：Nutrition and Health in Aging、Frailty in Older Adults、Balance, Gait, and Falls Prevention

BACKGROUND: The Sarcopenia Definitions and Outcomes Consortium (SDOC) sought to identify cut points for muscle strength and body composition measures derived from dual-energy x-ray absorptiometry (DXA) that discriminate older adults with slow walking speed. This article presents the core analyses used to guide the SDOC position statements. DESIGN: Cross-sectional data analyses of pooled data. SETTING: University-based research assessment centers. PARTICIPANTS: Community-dwelling men (n = 13,652) and women: (n = 5,115) with information on lean mass by DXA, grip strength (GR), and walking speed. MEASUREMENTS: Thirty-five candidate sarcopenia variables were entered into sex-stratified classification and regression tree (CART) models to agnostically choose variables and cut points that discriminate slow walkers (<0.80 m/s). Models with alternative walking speed outcomes were also evaluated (<0.60 and <1.0 m/s and walking speed treated continuously). RESULTS: . Women with GRTBF of less than 0.65 kg/kg were twice as likely to be slow walkers than women with GRTBF of 0.65 kg/kg or greater. Models with alternative walking speed outcomes selected only functions of GR as primary discriminators of slowness in both men and women. DXA-derived lean mass measures did not consistently discriminate slow walkers. CONCLUSION: GR with and without adjustments for body size and composition consistently discriminated older adults with slowness. CART models did not select DXA-based lean mass as a pr...