Sarcopenia, Sarcopenic Obesity and Functional Impairments in Older Adults: NHANES 1999–2004

Abstract

The Foundation for the NIH (FNIH) Sarcopenia Project validated cutpoints for appendicular lean mass (ALM) to identify individuals with functional impairment. We hypothesized the prevalence of sarcopenia and sarcopenic obesity would be similar based on the different FNIH criteria, increase with age, and be associated with risk of impairment limitations. We identified 4,984 subjects ≥60 years from the National Health and Nutrition Examination Surveys 1999–2004. Sarcopenia was defined using: ALM (males<19.75kg; females<15.02kg), and ALM adjusted for body mass index (BMI) (males<0.789; females<0.512). Sarcopenic obesity is defined as subjects fulfilling criteria for sarcopenia and obesity by body fat (men≥25%; females≥35%). Prevalence rates of both sarcopenia and sarcopenic obesity were evaluated with respect to sex, age category (60–69, 70–79, >80years) and race. We assessed the association of physical limitations, basic and instrumental activities of daily living (ADL) and sarcopenia status. The mean age was 70.5 years in males and 71.6 years in females. Half (50.8%, n=2,531) were female, and mean BMI was 28kg/m ² in both sexes. ALM was higher in males than in females (24.1 vs. 16.3; p<0.001) but fat mass was lower (30.9 vs. 42.0;p<0.001). In males, sarcopenia prevalence was 16.0% and 27.8% using the ALM and ALM/BMI criteria. In females, prevalence was 40.5% and 19.3% using the ALM and ALM/BMI criteria. Sarcopenia was associated with a 1.10 [0.86,1.41] and 0.93 [0.74,1.16], and 1.46 [1.10,1.94] and 2.13 [1.41,3.20], risk of physical limitations using the ALM and ALM/BMI definitions in males and females, respectively. Prevalence of sarcopenia and sarcopenic obesity vary greatly, and a uniform definition is needed to identify and characterize these high risk populations.