The role of muscle mass and body fat on disability among older adults: A cross-national analysis.
BACKGROUND
The aim of this study was to evaluate the association of sarcopenia and sarcopenic obesity with disability among older adults (≥65years old) in nine high-, middle- and low-income countries from Asia, Africa, Europe, and Latin America.


METHODS
Data were available for 53,289 people aged ≥18years who participated in the Collaborative Research on Ageing in Europe (COURAGE) survey conducted in Finland, Poland, and Spain, and the WHO Study on global AGEing and adult health (SAGE) survey conducted in China, Ghana, India, Mexico, Russia, and South Africa, between 2007 and 2012. Skeletal muscle mass, skeletal muscle mass index, and percent body fat were calculated with specific population formulas. Sarcopenia and sarcopenic obesity were defined by specific cut-offs used in previous studies. Disability was assessed with the WHODAS 2.0 score (range 0-100) with higher scores corresponding to higher levels of disability. Multivariable linear regression analysis was conducted with disability as the outcome.


RESULTS
The analytical sample consisted of 18,363 people (males; n=8116, females; n=10247) aged ≥65years with mean (SD) age 72.9 (11.1) years. In the fully-adjusted overall analysis, sarcopenic obesity was associated with greater levels of disability [b-coefficient 3.01 (95% CI 1.14-4.88)]. In terms of country-wise analyses, sarcopenia was associated with higher WHODAS 2.0 scores in China [b-coefficient 4.56 (95% CI: 3.25-5.87)], Poland [b-coefficient 6.66 (95% CI: 2.17-11.14)], Russia [b-coefficient 5.60 (95% CI: 2.03-9.16)], and South Africa [b-coefficient 7.75 (95% CI: 1.56-13.94)].


CONCLUSIONS
Prevention of muscle mass decline may contribute to reducing the global burden of disability.
['Tyrovolas|Stefanos|S|', 'Koyanagi|Ai|A|', 'Olaya|Beatriz|B|', 'Ayuso-Mateos|Jose Luis|JL|', 'Miret|Marta|M|', 'Chatterji|Somnath|S|', 'Tobiasz-Adamczyk|Beata|B|', 'Koskinen|Seppo|S|', 'Leonardi|Matilde|M|', 'Haro|Josep Maria|JM|']
D000273:Adipose Tissue D000328:Adult D000368:Aged D000375:Aging D015992:Body Mass Index D004185:Disability Evaluation D005060:Europe D005260:Female D014943:Global Health D054624:Health Status Disparities D006306:Health Surveys D006801:Humans D008297:Male D008875:Middle Aged D018482:Muscle, Skeletal D009765:Obesity D015995:Prevalence D012307:Risk Factors D055948:Sarcopenia
Disability Older adults Sarcopenia Sarcopenic obesity WHODAS 2.0