Besides Sarcopenia, Pre-Sarcopenia Also Predicts All-Cause Mortality in Older Chileans

Abstract

Purpose

Many studies have demonstrated that Sarcopenia causes a serious impact on health, including death in older adults. The objective of this study was to determine the association of sarcopenia and pre-sarcopenia with all-cause mortality in older Chileans.

Subjects and Methods

Follow-up of 2311 community-dwelling people ≥ 60y from the Alexandros cohort. Anthropometric measurements, handgrip strength, mobility, and physical performance tests were performed. Sarcopenia, pre-sarcopenia, and severe sarcopenia were defined using the 2010 European Working Group on Sarcopenia in Older People (EWGSOP1) algorithm. Muscle mass was estimated using a prediction model with cut-off points validated for the Chilean population. Physical performance was determined by 3 m walking speed or five chair-stands or time up go test (TUG). Mortality data were obtained from death certificates of the National Civil Registry. Life tables for survival data, Kaplan Meier estimations, and Cox regression were calculated.

Results

The prevalence of sarcopenia was 20.2% (95% CI:18.6% to 21.9%) and similar in both sexes; pre-sarcopenia was identified in 20.4% (95% CI:18.8% to 22.1%) of the sample. Kaplan Meier survival estimates demonstrated lower survival rates for the people with sarcopenia and pre-sarcopenia (Log rank test for equality of survivor functions: p<0.0001). A dose-response was observed in the survival rates according to the stages of sarcopenia, showing the lowest survival rates for the people with severe sarcopenia, followed by older adults with sarcopenia, pre-sarcopenia, and without sarcopenia (Log rank test for equality of survivor functions: p<0.0001). After adjusting for age, sex, nutritional status, and number of chronic diseases, hazard ratios for death showed higher risk for subjects with sarcopenia (HR=1.47, 95% CI:1.17–1.83) and pre-sarcopenia (HR=1.35, 95% CI:1.03–1.78) in comparison with people without sarcopenia.

Conclusion

The results confirm a dose–response increase in the risk of all-cause death in older adults with sarcopenia and pre-sarcopenia compared to non-sarcopenic individuals.

Keywords:

• cohort study
• survival probability
• predictive models
• skeletal muscle mass

Acknowledgment

This research was supported by the Chilean National Fund for Scientific and Technological Development (Fondecyt grant 1130947 and Fondef grant 15I10053).

Ethics

This study was conducted in accordance with the Declaration of Helsinki. The study and the consent form were approved by the ethics committee of the Institute of Nutrition and Food Technology. All subjects signed a consent form before any procedure was undertaken.

Disclosure

The authors report no conflicts of interest in this work.