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Sarcopenia and health-related outcomes: an umbrella review of observational studies

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Key summary points

AbstractSection Aim

To investigate associations of sarcopenia with adverse health-related outcomes, through an umbrella review method.

AbstractSection Findings

Sarcopenia appears to be significantly associated with several adverse outcomes in older people, with a strong evidence for increased risk of mortality, disability, and falls.

AbstractSection Message

Sarcopenia is associated with several adverse health-related outcomes in older people, indicating the need of assessing this condition in daily practice.

Abstract

Background

The clinical relevance of sarcopenia has increasingly been recognized. However, whether it is associated with the development of other medical conditions is still unclear. Therefore, we aimed to capture the scale of outcomes that have been associated with the presence of sarcopenia and systematically assess the quality, strength, and credibility of these associations using an umbrella review methodology.

Methods

A systematic review in several databases was carried out, until 20th February 2019. For each association, random-effects summary effect size, 95% confidence intervals (CIs), heterogeneity (I2), evidence for small-study effect, evidence for excess significance bias, and 95%-prediction intervals were estimated. We used these metrics to categorize the evidence of significant outcomes (p < 0.05) from class I (convincing) to class IV (weak), according to pre-established criteria.

Results

From 358 abstracts, 6 meta-analyses with 14 associations were included. Sarcopenia was associated with higher risk of other comorbidities and mortality in 11 of 14 outcomes explored. However, only 3 outcomes (i.e., association between sarcopenia and increased risk of death in community-dwelling older people [odds ratio, OR = 3.60; 95% CI 2.96–4.37; n = 14,305], disability [OR = 3.04; 95% CI 1.80–5.12; n = 8569], and falls [OR = 1.60; 95% CI 1.31–1.97; n = 12,261]) presented a highly suggestive evidence (class II). Other association was classified as having only a weak evidence.

Conclusion

Sarcopenia is associated with several adverse health-related outcomes in older people, and its associations with mortality, disability, and falls are supported by a highly suggestive evidence. The effect of interventions on sarcopenia to improve these outcomes needs to be investigated.

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Authors and Affiliations

  1. National Research Council, Neuroscience Institute, Aging Branch Via Giustiniani, 2, Padua, Italy

    Nicola Veronese & Stefania Maggi

  2. Primary Care Department Azienda, USL Toscana Sud Est, Grosseto, Italy

    Jacopo Demurtas

  3. Department of Geriatric Medicine, Bezmialem Vakif University, Istanbul, Turkey

    Pinar Soysal

  4. The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK

    Lee Smith

  5. Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany

    Gabriel Torbahn & Cornel Sieber

  6. Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany

    Daniel Schoene

  7. Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center, University of Freiburg, Freiburg, Germany

    Lukas Schwingshackl

  8. Kantonsspital Winterthur, Winterthur, Switzerland

    Cornel Sieber

  9. Center for Geriatric Medicine, University of Heidelberg, Agaplesion Bethanien Hospital, Heidelberg, Germany

    Jurgen Bauer

  10. Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy

    Matteo Cesari

  11. WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium

    Oliviere Bruyere, Jean-Yves Reginster & Charlotte Beaudart

  12. Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain

    Alfonso J. Cruz-Jentoft

  13. MRC Life Course Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK

    Cyrus Cooper

  14. NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK

    Cyrus Cooper

  15. Department of Geriatrics, Ghent University Hospital, Ghent, Belgium

    Mirko Petrovic

Authors
  1. Nicola Veronese
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  2. Jacopo Demurtas
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  3. Pinar Soysal
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  4. Lee Smith
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  14. Alfonso J. Cruz-Jentoft
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  15. Cyrus Cooper
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the Special Interest Groups in Systematic Reviews and Meta-analyses for healthy ageing Sarcopenia and Frailty and resilience in older persons of the European Geriatric Medicine Society (EuGMS)

Corresponding author

Correspondence to Nicola Veronese.

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Veronese, N., Demurtas, J., Soysal, P. et al. Sarcopenia and health-related outcomes: an umbrella review of observational studies. Eur Geriatr Med 10, 853–862 (2019). https://doi.org/10.1007/s41999-019-00233-w

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