The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access originally published online on January 30, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2009 64A(3):377-384; doi:10.1093/gerona/gln031
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Skeletal Muscle and Mortality Results From the InCHIANTI Study
1 Department of Gerontology, Geriatrics, and Physiatry, Catholic University of Sacred Heart, Rome, Italy
2 Department of Aging and Geriatric Research, College of Medicine, Institute on Aging, University of Florida, Gainesville
3 Tuscany Health Regional Agency, Florence, Italy
4 Geriatric Rehabilitation Unit, Health Agency of Florence, Italy
5 Laboratory of Epidemiology, Demography, and Biometry
6 Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, Maryland
Correspondence Address correspondence to Matteo Cesari, MD, PhD, Department of Aging and Geriatric Research, College of Medicine, Institute on Aging, University of Florida, PO Box 112610, Gainesville, FL 32611. Email: macesari{at}gmail.com
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Abstract |
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Background: Sarcopenia, the age-related loss of muscle mass, may not be an isolated process but is associated with an increase in fat mass. The aim of this study was to estimate the mortality risk of sarcopenia in the presence or absence of obesity.
Methods: Data are from 934 participants aged 65 years or older, enrolled in the "Invecchiare in Chianti" study, and followed for 6 years. At baseline, a peripheral quantitative computerized tomography (pQCT) scan was performed on all participants to evaluate the muscle density, and the muscular and fat cross-sectional areas of the calf. Walking speed was measured on a 7-m track. Cox proportional hazard models were performed to estimate the association of pQCT measures (per 1 standard deviation increase) with mortality.
Results: Unadjusted analyses showed significant associations of muscle density (hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.69–0.88), muscle area (HR 0.75, 95% CI 0.66–0.86), and fat area (HR 0.82, 95% CI 0.73–0.92) with mortality. After adjustment for potential confounders, no body composition parameter was significantly associated with mortality. Walking speed (used as a reference measure to verify whether the negative results were due to peculiarities of the study sample) confirmed its well-established association with mortality risk (HR 0.73, 95% CI 0.60–0.88). These results did not change after the analyses were stratified according to sarcopenia and body mass index groups, and restricted to participants with frailty or a high inflammatory profile.
Conclusions: Calf skeletal muscle and fat mass are not significant risk factors for mortality in community-dwelling older adults. Walking speed confirmed to be a powerful predictor of health-related events.
Keywords Skeletal muscle; Body composition; Fat mass; Walking speed; Obesity; Sarcopenia; Mortality; InCHIANTI
Received: August 8, 2007; Accepted: June 25, 2008