Instruments to assess sarcopenia and physical frailty in older people living in a community (care) setting: similarities and discrepancies

Donja M Mijnarends, Jos M G A Schols, Judith M M Meijers, Frans E S Tan, Sjors Verlaan, Yvette C Luiking, John E Morley, Ruud J G Halfens
Journal of the American Medical Directors Association 2015, 16 (4): 301-8

OBJECTIVES: Both sarcopenia and physical frailty are geriatric syndromes causing loss of functionality and independence. This study explored the association between sarcopenia and physical frailty and the overlap of their criteria in older people living in different community (care) settings. Moreover, it investigated the concurrent validity of the FRAIL scale to assess physical frailty, by comparison with the widely used Fried criteria.

DESIGN: Data were retrieved from the cross-sectional Maastricht Sarcopenia Study (MaSS).

SETTING: The study was undertaken in different community care settings in an urban area (Maastricht) in the south of the Netherlands.

PARTICIPANTS: Participants were 65 years or older, gave written informed consent, were able to understand Dutch language, and were not wheelchair bound or bedridden.

INTERVENTION: Not applicable.

MEASUREMENTS: Sarcopenia was identified using the algorithm of the European Working Group on Sarcopenia in Older People. Physical frailty was assessed by the Fried criteria and by the FRAIL scale. Logistic regression was performed to assess the association between sarcopenia and physical frailty measured by the Fried criteria. Spearman correlation was performed to assess the concurrent validity of the FRAIL scale compared with the Fried criteria.

RESULTS: Data from 227 participants, mean age 74.9 years, were analyzed. Sarcopenia was identified in 23.3% of the participants, when using the cutoff levels for moderate sarcopenia. Physical frailty was identified in 8.4% (≥3 Fried criteria) and 9.3% (≥3 FRAIL scale criteria) of the study population. Sarcopenia and physical frailty were significantly associated (P = .022). Frail older people were more likely to be sarcopenic than those who were not frail. In older people who were not frail, the risk of having sarcopenia increased with age. Next to poor grip strength (78.9%) and slow gait speed (89.5%), poor performance in other functional tests was common in frail older people. The 2 physical frailty scales were significantly correlated (r = 0.617, P < .001).

CONCLUSION: Sarcopenia and physical frailty were associated and partly overlap, especially on parameters of impaired physical function. Some evidence for concurrent validity between the FRAIL scale and Fried criteria was found. Future research should elicit the value of combining sarcopenia and frailty measures in preventing disability and other negative health outcomes.

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