Strong Relation between Muscle Mass Determined by D3-creatine Dilution, Physical Performance and Incidence of Falls and Mobility Limitations in a Prospective Cohort of Older Men

Peggy M Cawthon, Eric S Orwoll, Katherine E Peters, Kristine E Ensrud, Jane A Cauley, Deborah M Kado, Marcia L Stefanick, James M Shikany, Elsa S Strotmeyer, Nancy W Glynn, Paolo Caserotti, Mahalakshmi Shankaran, Marc Hellerstein, Steven R Cummings, William J Evans, Osteoporotic Fractures in Men (MrOS) Study Research Group

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Abstrakt

Background: Direct assessment of skeletal muscle mass in older adults is clinically challenging. Relationships between lean mass and late-life outcomes have been inconsistent. The D3-creatine dilution method provides a direct assessment of muscle mass.

Methods: Muscle mass was assessed by D3-creatine (D3Cr) dilution in 1,382 men (mean age, 84.2 yrs). Participants completed the Short Physical Performance Battery (SPPB); usual walking speed (6 meters); and DXA lean mass. Men self-reported mobility limitations (difficulty walking 2-3 blocks or climbing 10 steps); recurrent falls (2+); and serious injurious falls in the subsequent year. Across quartiles of D3Cr muscle mass/body mass, multivariate linear models calculated means for SPPB and gait speed; multivariate logistic models calculated odds ratios for incident mobility limitations or falls.

Results: Compared to men in the highest quartile, those in the lowest quartile of D3Cr muscle mass/body mass had slower gait speed (Q1: 1.04 vs Q4: 1.17 m/s); lower SPPB (Q1: 8.4 vs Q4: 10.4 points); greater likelihood of incident serious injurious falls (OR Q1 vs Q4: 2.49, 95% CI: 1.37, 4.54); prevalent mobility limitation (OR Q1 vs Q4,: 6.1, 95%CI: 3.7, 10.3) and incident mobility limitation (OR Q1 vs Q4: 2.15 95% CI: 1.42, 3.26); p for trend <.001 for all. Results for incident recurrent falls were in the similar direction (p=0.156). DXA lean mass had weaker associations with the outcomes.

Conclusions: Unlike DXA lean mass, low D3Cr muscle mass/body mass is strongly related to physical performance, mobility and incident injurious falls in older me.

OriginalsprogEngelsk
TidsskriftThe journals of gerontology. Series A, Biological sciences and medical sciences
Vol/bind74
Udgave nummer6
Sider (fra-til)844-852
ISSN1079-5006
DOI
StatusUdgivet - 16. maj 2019

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