Sarcopenia, Calf Circumference, and Physical Function of Elderly Women: A Cross-Sectional Study
Yves Rolland MD
*Internal Medicine Service and Gerontology Clinic (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France; † Exploration of Respiratory Function Service and Sports Medicine, Hôpital Purpan, Toulouse, France; and ‡ Epidemiology and Community Health Laboratory, Faculté de Médecine, Toulouse, France.
Search for more papers by this authorValérie Lauwers-Cances MD
*Internal Medicine Service and Gerontology Clinic (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France; † Exploration of Respiratory Function Service and Sports Medicine, Hôpital Purpan, Toulouse, France; and ‡ Epidemiology and Community Health Laboratory, Faculté de Médecine, Toulouse, France.
Search for more papers by this authorMaxime Cournot MD
*Internal Medicine Service and Gerontology Clinic (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France; † Exploration of Respiratory Function Service and Sports Medicine, Hôpital Purpan, Toulouse, France; and ‡ Epidemiology and Community Health Laboratory, Faculté de Médecine, Toulouse, France.
Search for more papers by this authorFati Nourhashémi MD
*Internal Medicine Service and Gerontology Clinic (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France; † Exploration of Respiratory Function Service and Sports Medicine, Hôpital Purpan, Toulouse, France; and ‡ Epidemiology and Community Health Laboratory, Faculté de Médecine, Toulouse, France.
Search for more papers by this authorWilliam Reynish MD
*Internal Medicine Service and Gerontology Clinic (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France; † Exploration of Respiratory Function Service and Sports Medicine, Hôpital Purpan, Toulouse, France; and ‡ Epidemiology and Community Health Laboratory, Faculté de Médecine, Toulouse, France.
Search for more papers by this authorDaniel Rivière MD
*Internal Medicine Service and Gerontology Clinic (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France; † Exploration of Respiratory Function Service and Sports Medicine, Hôpital Purpan, Toulouse, France; and ‡ Epidemiology and Community Health Laboratory, Faculté de Médecine, Toulouse, France.
Search for more papers by this authorBruno Vellas MD
*Internal Medicine Service and Gerontology Clinic (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France; † Exploration of Respiratory Function Service and Sports Medicine, Hôpital Purpan, Toulouse, France; and ‡ Epidemiology and Community Health Laboratory, Faculté de Médecine, Toulouse, France.
Search for more papers by this authorHélène Grandjean MD
*Internal Medicine Service and Gerontology Clinic (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France; † Exploration of Respiratory Function Service and Sports Medicine, Hôpital Purpan, Toulouse, France; and ‡ Epidemiology and Community Health Laboratory, Faculté de Médecine, Toulouse, France.
Search for more papers by this authorYves Rolland MD
*Internal Medicine Service and Gerontology Clinic (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France; † Exploration of Respiratory Function Service and Sports Medicine, Hôpital Purpan, Toulouse, France; and ‡ Epidemiology and Community Health Laboratory, Faculté de Médecine, Toulouse, France.
Search for more papers by this authorValérie Lauwers-Cances MD
*Internal Medicine Service and Gerontology Clinic (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France; † Exploration of Respiratory Function Service and Sports Medicine, Hôpital Purpan, Toulouse, France; and ‡ Epidemiology and Community Health Laboratory, Faculté de Médecine, Toulouse, France.
Search for more papers by this authorMaxime Cournot MD
*Internal Medicine Service and Gerontology Clinic (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France; † Exploration of Respiratory Function Service and Sports Medicine, Hôpital Purpan, Toulouse, France; and ‡ Epidemiology and Community Health Laboratory, Faculté de Médecine, Toulouse, France.
Search for more papers by this authorFati Nourhashémi MD
*Internal Medicine Service and Gerontology Clinic (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France; † Exploration of Respiratory Function Service and Sports Medicine, Hôpital Purpan, Toulouse, France; and ‡ Epidemiology and Community Health Laboratory, Faculté de Médecine, Toulouse, France.
Search for more papers by this authorWilliam Reynish MD
*Internal Medicine Service and Gerontology Clinic (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France; † Exploration of Respiratory Function Service and Sports Medicine, Hôpital Purpan, Toulouse, France; and ‡ Epidemiology and Community Health Laboratory, Faculté de Médecine, Toulouse, France.
Search for more papers by this authorDaniel Rivière MD
*Internal Medicine Service and Gerontology Clinic (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France; † Exploration of Respiratory Function Service and Sports Medicine, Hôpital Purpan, Toulouse, France; and ‡ Epidemiology and Community Health Laboratory, Faculté de Médecine, Toulouse, France.
Search for more papers by this authorBruno Vellas MD
*Internal Medicine Service and Gerontology Clinic (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France; † Exploration of Respiratory Function Service and Sports Medicine, Hôpital Purpan, Toulouse, France; and ‡ Epidemiology and Community Health Laboratory, Faculté de Médecine, Toulouse, France.
Search for more papers by this authorHélène Grandjean MD
*Internal Medicine Service and Gerontology Clinic (Professeur Albarède), Hôpital La Grave-Casselardit, Toulouse, France; † Exploration of Respiratory Function Service and Sports Medicine, Hôpital Purpan, Toulouse, France; and ‡ Epidemiology and Community Health Laboratory, Faculté de Médecine, Toulouse, France.
Search for more papers by this authorAbstract
OBJECTIVES: To determine whether calf circumference (CC), related to appendicular skeletal muscle mass, can be used as a measure of sarcopenia and is related to physical function.
DESIGN: Retrospective analysis of data from 1992 to 1994 of the European Patient Information and Documentation Systems Study.
SETTING: Community setting in France.
PARTICIPANTS: One thousand four hundred fifty-eight French women aged 70 and older without previous history of hip fracture were recruited from the electoral lists.
MEASUREMENTS: Muscular mass was assessed using dual-energy x-ray absorptiometry (DEXA). CC was measured using a tape measure. Anthropometric measurements (height; weight; and waist, hip, and calf circumference), strength markers (grip strength), and self-reported physical function were also determined. Sarcopenia was defined (using DEXA) as appendicular skeletal muscle mass (weight (kg)/height (m2)) less than two standard deviations below the mean of a young female reference group.
RESULTS: The prevalence of sarcopenia was 9.5%. CC was correlated with appendicular skeletal muscle mass (r = 0.63). CC under 31 cm was the best clinical indicator of sarcopenia (sensitivity = 44.3%, specificity = 91.4%). CC under 31 cm was associated with disability and self-reported physical function but not sarcopenia (defined using DEXA), independent of age, comorbidity, obesity, income, health behavior, and visual impairment.
CONCLUSION: CC cannot be used to predict sarcopenia defined using DEXA but provides valuable information on muscle-related disability and physical function.
REFERENCES
- 1 Rosenberg IH. Summary comments. Am J Clin Nutr 1989; 50: 1231–1233.
- 2 Baumgartner RN, Koehler KM, Gallagher D et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 1998; 147: 755–763.
- 3 Carmeli E, Reznick A. The physiology and biochemistry of skeletal muscle atrophy as a function of age. Proc Soc Exp Biol Med 1994; 206: 103–113.
- 4
Baumgartner RN,
Stauber PM,
McHugh D et al. Cross-sectional age differences in body composition in persons 60+ years of age.
J Gerontol A Biol Sci Med Sci
1995; 50A: M307–M316.
10.1093/gerona/50A.6.M307 Google Scholar
- 5 Poehlman ET, Toth MJ, Gardner AW. Changes in energy balance and body composition at menopause: A controlled longitudinal study. Ann Intern Med 1995; 123: 673–675.
- 6 Jauffret M, Jusot JF, Bonnefoy M. Marqueurs anthropométriques et malnutrition de la personne âgée: intérêt de la circonférence du mollet. Age Nutr 1999; 10: 163–169.
- 7 Heymsfield SB, Gallagher D, Visser M et al. Measurement of skeletal muscle: Laboratory and epidemiological methods. J Gerontol A Biol Sci Med Sci 1995; 50A Spec No: 23–29.
- 8
Chumlea WC,
Guo SS,
Vellas B et al. Techniques of assessing muscle mass and function (sarcopenia) for epidemiological of the elderly.
J Gerontol A Biol Sci Med Sci
1995; 50A: 45–51.
10.1093/gerona/50A.Special_Issue.45 Google Scholar
- 9 Dargent-Molina P, Favier F, Grandjean H et al. Fall-related factors and risk of hip fracture: The EPIDOS prospective study. Lancet 1996; 348: 145–149.
- 10 Lohman TG, Roche AF, Martorell R, eds. Anthropometric standardization reference manual. Champaign, IL: Human Kinetics, Inc., 1988.
- 11 Heymsfield SB, Smith R, Aulet M et al. Appendicular skeletal muscle mass: Measurement by dual-photon absorptiometry. Am J Clin Nutr 1990; 52: 214–218.
- 12 Gallagher D, Visser M, De Meersman RE et al. Appendicular skeletal muscle mass. Effects of age, gender, and ethnicity. J Appl Physiol 1997; 83: 229–239.
- 13 Katz S, Downs TD, Cash HR et al. Progress in development of the index of ADL. Gerontologist 1970; 10: 20–30.
- 14 Lawton MP, Brody EM. Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9: 179–186.
- 15 Melton LJ, Khosla S, Crowson CS et al. Epidemiology of sarcopenia. J Am Geriatr Soc 2000; 48: 625–630.
- 16 Martin AD, Spenst LF, Drinkwater DT et al. Anthropometric estimation of muscle mass in men. Med Sci Sports Exerc 1990; 22: 729–733.
- 17 Heymsfield SB, Olafson RP, Kutner MH et al. A radiographic method of quantifying protein-calorie undernutrition. Am J Clin Nutr 1979; 32: 693–702.
- 18 Friedman PJ, Campbell AJ, Caradoc-Davies TH. Prospective trial of a new diagnostic criterion for severe wasting malnutrition in the elderly. Age Ageing 1985; 14: 149–154.
- 19 Patrick JM, Bassey EJ, Fentem PH. Changes in body fat and muscle in manual workers at and after retirement. Eur J Appl Physiol 1982; 49: 187–196.
- 20 Heymsfield SB, McManus C, Smith J et al. Anthropometric measurement of muscle mass: Revised equations for calculating bone-free arm muscle area. Am J Clin Nutr 1982; 36: 680–690.
- 21 Dutta C, Hadley E, Lexel J. Sarcopenia and physical performance in old age. Overview. Muscle Nerve 1997; 5: S5–S9.
- 22 Schwartz R. Sarcopenia and physical performance in old age: introduction. Muscle Nerve 1997; 5: S10–S12.
- 23 Brown M, Sinacore D, Host HH. The relationship of strength to function in the older adult. J Gerontol 1995; 50 Spec No: 55–59.
- 24 Bassey EJ, Bendall MJ, Pearson M. Muscle strength in the triceps surae and objectively measured customary walking activity in men and women over 65 years of age. Clin Sci 1988; 74: 85–89.
- 25 Guralnik JM, Ferrucci L, Pieper C et al. Lower-extremity function and subsequent disability: Consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci 2000; 55A: M221–M231.
- 26 Schenkman M, Hughes MA, Samsa G et al. The relative importance of strength and balance in chair rise by functionally impaired older individuals. J Am Geriatr Soc 1996; 44: 1441–1446.
- 27 Ferrucci L, Guralnik J, Buchner D et al. Departure from linearity in the relationship between measures of muscular strength and physical performance of the lower extremities: The women's health and aging study. J Gerontol A Biol Sci Med Sci 1997; 52A: M275–M285.
- 28 Bassey EJ. Measurement of muscle strength and power. Muscle Nerve 1997; 5: S44–S46.