Sarcopenia in older people with chronic airway diseases: the Rotterdam study

Introduction Sarcopenia is a heterogeneous skeletal muscle disorder involving the loss of muscle mass and function. However, the prevalence of sarcopenia based on the most recent definition remains to be determined in older people with chronic airway diseases.

Objective To evaluate sarcopenia prevalence and association with chronic airway diseases and its lung function in an older population, using the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria.

Methods We performed a cross-sectional analysis in 5082 participants (mean age, 69.0±8.8 years, 56% females) from the Rotterdam Study. Participants with interpretable spirometry and an available assessment of sarcopenia were included. The appendicular skeletal muscle mass index (ASMI) and handgrip strength (HGS) were assessed using dual-energy X-ray absorptiometry (DXA) and a hydraulic hand dynamometer, respectively. We analysed the association between sarcopenia and chronic airway diseases by using regression models adjusted for age, sex, smoking status, total fat percentage and other relevant confounders.

Results Participants with chronic airway diseases had higher prevalence of probable sarcopenia (12.0%, 95% CI 10.2; 13.8) and confirmed sarcopenia (3.0%, 95% CI 2.1; 3.9) than without. Chronic airway diseases were associated with “probable sarcopenia” (OR=1.28, 95%CI 1.02, 1.60), “confirmed sarcopenia” (OR=2.13, 95%CI 1.33, 3.43), reduced HGS (β=−0.51 [−0.90; −0.11]) and reduced ASMI (β=−0.19 [−0.25; −0.14]). FEV₁<80% was associated with lower HGS (β=−1.03 [−1.75; −0.31]) and lower ASMI (β=−0.25 [−0.36; −0.15]) than FEV₁≥80%.

Conclusion Sarcopenia was prevalent and associated with chronic airway diseases among older population. These results suggest the need for early diagnosis of sarcopenia in older people with chronic airway diseases by applying EWGSOP2 recommendations.