Introduction: This study delves into a Comparative Definition analysis of sarcopenia, examining how effectively different established definitions of this condition predict the likelihood of falls in older adults. Our research compares seven existing sarcopenia definitions alongside two related definitions to determine their predictive power regarding fall rates among community-dwelling senior citizens.
Methods: Our research involved a cohort of 445 community-living seniors, with an average age of 71, and 45% being men. These participants were meticulously monitored for falls over a 3-year period, using thorough fall assessments. To compare fall rates between individuals classified as sarcopenic and non-sarcopenic, we employed multivariate Poisson regression analyses. These analyses were adjusted for gender and treatment, which was initially designed to test vitamin D plus calcium against a placebo. Among the seven definitions assessed, three categorized sarcopenia based solely on low lean mass—namely, Baumgartner, Delmonico 1, and Delmonico 2. Conversely, four definitions—Fielding, Cruz-Jentoft, Morley, and Muscaritoli—required both low muscle mass and diminished performance in functional tests to diagnose sarcopenia. The two related definitions considered were Studenski 1, based only on low lean mass, and Studenski 2, identifying sarcopenia as low lean mass contributing to weakness.
Results: Over the 3-year study, 231 of the 445 participants experienced falls, totaling 514 falls. The Baumgartner definition, relying solely on low lean mass, and the Cruz-Jentoft definition, which incorporates both low lean mass and decreased functional performance, emerged as the most effective in predicting prospective fall rates. Specifically, the Baumgartner definition (11% sarcopenia prevalence) showed a fall rate Ratio Rate (RR) of 1.54 (95% CI 1.09-2.18) for sarcopenic versus non-sarcopenic individuals. The Cruz-Jentoft definition (7.1% sarcopenia prevalence) indicated an even higher RR of 1.82 (95% CI 1.24-2.69). Definitions by Delmonico 1, Fielding, and Morley also suggested a trend towards higher fall rates in sarcopenic individuals, although these results were not statistically significant.
Conclusion: In conclusion, our comparative analysis indicates that the Baumgartner and Cruz-Jentoft definitions of sarcopenia demonstrate the strongest predictive validity for identifying seniors at a higher risk of falls. These findings highlight the importance of definition choice when assessing sarcopenia and its implications for fall prevention strategies in older populations.
