Importance of skeletal muscle-related diagnostic components of Sarcopenia and adverse outcomes in geriatric patients

BACKGROUND: International groups propose different approaches to assess muscle mass and skeletal muscle function, raising the question of which diagnostic parameter best reflects muscle quantity and quality and contributes to adverse outcomes. AIM: The aim of the study was to evaluate diagnostic accuracy of sarcopenia components and identify their association with adverse outcomes in geriatric patients. METHODS: The study included 230 subjects aged ≥ 65 years, 70 men and 160 women, who presented for a consultation at a healthcare organization in Saint Petersburg, Russia. The median age of the patients was 75 (68–79) years. Sarcopenia was diagnosed using the European Working Group on Sarcopenia in Older People criteria, 2nd edition (2018). Muscle mass was calculated using the Appendicular Muscle Mass Index based on dual-energy X-ray absorptiometry. Muscle strength was measured using a hand dynamometer, and physical performance was assessed using the Short Physical Performance Battery. Comorbidities were assessed using the Charlson Comorbidity Index. Health-related quality of life was assessed using the validated Russian version of the Sarcopenia Quality of Life questionnaire. RESULTS: The higher risk of sarcopenia was reported in subjects with low muscle strength (odds ratio: 8.491; 95% confidence interval: 4.432, 16.320), low physical performance as measured by the Short Physical Performance Battery due to impaired balance (odds ratio: 2.145; 95% confidence interval: 1.452, 3.168) and by the Timed Up and Go Test (odds ratio: 2.083; 95% confidence interval: 1.284, 3.378). Low muscle strength and low muscle mass were associated with falls, comorbidities, and health-related quality of life (p 0.05). Low physical performance was associated with all adverse outcomes assessed in subjects aged ≥ 65 years (p 0.05). CONCLUSION: Hand dynamometry and balance testing are important diagnostic tools for sarcopenia. All diagnostic components of sarcopenia were associated with falls, severe comorbidities, and reduced health-related quality of life in subjects aged ≥ 65 years. A low total score on the Short Physical Performance Battery increased the risk of fractures at multiple sites.