Advertisement

Functional Measures of Sarcopenia: Prevalence, and Associations with Functional Disability in 10,892 Adults Aged 65 Years and Over from Six Lower- and Middle-Income Countries

  • Sharon L. Brennan-OlsenEmail author
  • Steven J. Bowe
  • Paul Kowal
  • Nirmala Naidoo
  • Nekehia T. Quashie
  • Geeta Eick
  • Sutapa Agrawal
  • Catherine D’Este
Original Research

Abstract

Identification of sarcopenia in lower- and middle-income countries (LMICs) is limited by access to technologies that assess muscle mass. We investigated associations between two functional measures of sarcopenia, grip strength and gait speed (GS), with functional disability in adults from six LMICs. Data were extracted from the World Health Organization (WHO) Study on global AGEing and adult health Wave 1 (2007–2010) for adults (≥ 65 years) from China, Mexico, Ghana, India, Russia and South Africa (n = 10,892, 52.8% women). We calculated country-specific prevalence of low grip strength, slow GS (≤ 0.8 m/s), and both measures combined. Using multivariable negative binomial regression, we separately assessed associations between low grip strength, slow GS, and both measures combined, with the WHO Disability Assessment Schedule 2.0, accounting for selected socioeconomic factors. In women, low grip strength ranged from 7 in South Africa to 51% in India; in men, it ranged from 17 in Russia to 51% in Mexico. Country-specific proportions of slow GS ranged from 77 in Russia, to 33% in China. The concomitant presence of both was the lowest in South Africa and the highest in India (12.3% vs. 33%). Independent of age, those with both low grip strength and slow GS had between 1.2- and 1.5-fold worse functional disability scores, independent of comorbidities, low education, and low wealth (all country-dependent). Low grip strength, slow GS, and the combination of both, were all associated with higher levels of functional disability, thus indicating these objective measures offer a reasonably robust estimate for potential poor health outcomes.

Keywords

Grip strength Gait speed Function Strength Disability Lower- and middle-income countries Socioeconomic conditions 

Notes

Acknowledgements

SLB-O is the recipient of a Career Development Fellowship from the National Health and Medical Research Council (NHMRC) of Australia (1107510). SAGE is supported by WHO and the Division of Behavioral and Social Research (BSR) at the US National Institute on Aging (NIA) through interagency agreements (OGHA 04034785; YA1323-08-CN-0020; Y1-AG-1005-01) with WHO. In addition, the governments of Shanghai, China and South Africa provided financial or other support for Wave 1 of their national SAGE study. All collaborating institutions provided substantial resources to conduct their respective studies. We thank the participants in each country for their contributions to SAGE and acknowledge the contributions and expertise of the country-specific investigators and their respective survey teams. We acknowledge the intellectual input of Dr Jesse Zanker and Mr Steven Phu regarding recommended measurement of, and cut-points for, gait speed and grip strength in terms of sarcopenia assessment.

Compliance with Ethical Standards

Conflict of interest

Sharon L. Brennan-Olsen, Steven J. Bowe, Paul Kowal, Nirmala Naidoo, Nekehia T. Quashie, Geeta Eick, Sutapa Agrawal, and Catherine D’Este declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article contains studies with human subjects and all participants gave written informed consent in accordance with the Declaration of Helsinki. This study did not include animals.

Supplementary material

223_2019_609_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 14 kb)

References

  1. 1.
    Scott D, de Courten B, Ebeling PR (2016) Sarcopenia: a potential cause and consequence of type 2 diabetes in Australia’s ageing population? Med J Aust 205:329–333CrossRefGoogle Scholar
  2. 2.
    Narici MV, Mafulli N (2010) Sarcopenia: characteristics, mechanisms and functional significance. Br Med Bull 95:139–159CrossRefGoogle Scholar
  3. 3.
    Miljkovic N, Lim J-Y, Miljkovic I, Frontera WR (2015) Aging of skeletal muscle fibers. Ann Rehabil Med 39:155–162CrossRefGoogle Scholar
  4. 4.
    Schaap LA, van Schoor NM, Lips P, Visser M (2018) Associations of sarcopenia definitions, and their components, with the incidence of recurrent falling and fractures: the Longitudinal Aging Study Amsterdan. J Gerontol 73:1199–1204CrossRefGoogle Scholar
  5. 5.
    Mijnarends DM, Schols JMGA, Halfens RJG, Meijers JMM, Luiking YC, Verlaan S, Evers SMAA (2016) Burden-of-illness of Dutch community-dwelling older adults with sarcopenia: health related outcomes and costs. Eur Geriatr Med 7:276–284CrossRefGoogle Scholar
  6. 6.
    Reijnierse EM, Trappenburg MC, Leter MH, Blauw GJ, Sipila S, Sillanpaa E, Narici MV, Hogrel JY, Butler-Browne G, McPhee JS, Gapeyeva H, Paasuke M, de van der Schueren MA, Meskers CG, Maier AB (2015) The impact of different diagnostic criteria on the prevalence of sarcopenia in healthy elderly participants and geriatric outpatients. Gerontology 61:491–496CrossRefGoogle Scholar
  7. 7.
    Volpato S, Bianchi L, Cherubini A, Landi F, Maggio M, Savino E, Bandinelli S, Ceda GP, Guralnik JM, Zuliani G, Ferrucci L (2014) Prevalence and clinical correlates of sarcopenia in community-dwelling older people: application of the EWGSOP definition and diagnostic algorithm. J Gerontol Ser A 69:438–446CrossRefGoogle Scholar
  8. 8.
    Beaudart C, Rizzoli R, Bruyere O, Reginster J-Y, Biver E (2014) Sarcopenia: burden and challenges for public health. Arch Public Health 72:45CrossRefGoogle Scholar
  9. 9.
    Landi F, Liperoti R, Russo A et al (2012) Sarcopenia as a risk factor for falls in elderly individuals: results from the ilSIRENTE study. Clin Nutr 31:652–658CrossRefGoogle Scholar
  10. 10.
    Clark BC, Manini TM (2008) Sarcopenia dynapenia. J Gerontol Ser A 63:829–834CrossRefGoogle Scholar
  11. 11.
    Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M, Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2 (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48:16–31CrossRefGoogle Scholar
  12. 12.
    Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, Chou MY, Chen LY, Hsu PS, Krairit O, Lee JS, Lee Y, Liang CK, Limpawattana P, Lin CS, Peng LN, Satake S, Suzuki T, Won CH, Wu SN, Zhang T, Zeng P, Akishita M, Aria H (2014) Sarcopenia in Asia: consensus report of the Asian Working Group for sarcopenia. J Am Med Dir Assoc 15:95–101CrossRefGoogle Scholar
  13. 13.
    Stringhini S, Carmeli C, Jokela M, Avendano M, McCrory C, d’Errico A, Bochud M, Barros H, Cost G, Chadeau-Hyam M, Delpierre C, Gandini M, Fraga S, Goldberg M, Giles GG, Lassale C, Kenny RA, Kelly-Irving M, Paccaud F, Layte R, Muennig P, Marmot MG, Ribeiro AI, Severi G, Steptoe A, Shipley MJ, Zins M, Mackenbach JP, Vineis P, Kivimaki M, for the LIFEPATH Consortium (2018) Socioeconomic status, non-communicable disease risk factors, and walking speed in older adults: multi-cohort population based study. BMJ 360:k1046CrossRefGoogle Scholar
  14. 14.
    Ramlagan S, Peltzer K, Phaswana-Mafuya N (2014) Hand grip strength and associated factors in non-institutionalised men and women 50 years and older in South Africa. BMC Res Notes 7:8CrossRefGoogle Scholar
  15. 15.
    Kowal P, Chatterji S, Naidoo N, Biritwum R, Fan W, Ridaura RL, Maximova T, Arokiasamy P, Phaswana-Mafuya N, Williams S, Snodgrass JJ, Minicuci N, E’Este C, Peltzer K, Boerma JT, the SAGE collaborators (2012) Data resource profile: the World Health Organization Study on global AGEing and adult health (SAGE). Int J Epidemiol 41:1639–1649CrossRefGoogle Scholar
  16. 16.
    Chatterji S (2013) World Health Organization’s (WHO) Study global AGEing and adult health (SAGE). BMC Proc 7:S1CrossRefGoogle Scholar
  17. 17.
    World Health Organization (2010) World Health Organization Disability Assessment Schedule II (WHO-DAS II). WHO. http://www.who.int/classifications/icf.en/ Accessed Aug 2018
  18. 18.
    World Health Organization (2010) Measuring health and disability: manual for WHO disability assessment schedule (WHODAS 2.0). In: Ustun TB, Kostanjsek N, Chatterji S, Rehm J (ed). WHO, GenevaGoogle Scholar
  19. 19.
    World Health Organization (2018) WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). https://www.who.int/classifications/icf/more_whodas/en/) Accessed Feb 2019
  20. 20.
    World Health Organization (2000) The Asia-Pacific perspective: redefining obesity and its treatment. WHO Western Pacific Region, GenevaGoogle Scholar
  21. 21.
    Brennan-Olsen SLSS, Viikari-Juntura E, Ackerman IN, Bowe SJ, Kowal P, Naidoo N, Chatterji S, Wluka AE, Leech MT, Page RS, Sanders KM, Gomez F, Duque G, Green D, Mohebbi M (2018) Arthritis diagnosis and symptoms are positively associated with specific physical job exposures in lower- and middle-income countries: cross-sectional results from the World Health Organization’s Study on global AGEing and adult helath (SAGE). BMC Public Health 8:1Google Scholar
  22. 22.
    Cleland CLHR, Kee F, Cupples ME, Sallis JF, Tully MA (2014) Validity of the Global Physical Activity Questionnaire (GPAQ) in assessing levels and change in moderate-vigorous physical activity and sedentary behaviour. BMC Public Health 14:1255CrossRefGoogle Scholar
  23. 23.
    Gaskin CJ, Orellana L (2018) Factors associated with physical activity and sedentary behaviour in older adults from six low- and middle-income countries. Int J Environ Res Public Health 15:908CrossRefGoogle Scholar
  24. 24.
    Bull FC, Maslin TS, Armstrong T (2009) Global Physical Activity Questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health 6:790–804CrossRefGoogle Scholar
  25. 25.
    Herrmann SD, Heumann KJ, Der Ananian CA, Ainsworth BE (2013) Validity and reliability of the Global Physical Activity Questionnaire (GPAQ). Meas Phys Educ Exerc Sci 17:221–235CrossRefGoogle Scholar
  26. 26.
    Chu AHY, Ng SHX, Koh D, Muller-Riemenschneider F (2015) Reliability and validity of the self- and interviewer-administered versions of the Global Physical Activity Questionnaire (GPAQ). PLoS ONE 10:e0136944CrossRefGoogle Scholar
  27. 27.
    World Health Organization (2010) Global recommendations on physical activity for health. WHO, GenevaGoogle Scholar
  28. 28.
    Gunasekaran V, Banerjee J, Dwivedi SN, Upadhyay AD, Chatterjee P, Dey AB (2016) Normal gait speed, grip strength and thirty seconds chair stand test among older Indians. Arch Gerontol Geriatr 67:171–178CrossRefGoogle Scholar
  29. 29.
    Zeng P, Wu S, Han Y, Liu J, Zhang Y, Zhang E, Zhang Y, Gong H, Pang J, Tang Z, Liu H, Zheng X, Zhang T (2015) Differences in body composition and physical functions associated with sarcopenia in Chinese elderly: reference values and prevalence. Arch Gerontol Geriatr 60:118–123CrossRefGoogle Scholar
  30. 30.
    Bohannon RW (2015) Muscle strength: clinical and prognostic value of hand-grip dynamometry. Curr Opin Clin Nutr Metab Care 18:465–470CrossRefGoogle Scholar
  31. 31.
    Alley DE, Shardell MD, Peters KW, McLean RR, Dam T-TL, Kenny AM, Fragala MS, Harris TB, Kiel DP, Guralnik JM, Ferrucci L, Kritchevsky SB, Studenski SA, Vassileva MT, Cawthon PM (2014) Grip strength cutpoints for the identification of clinically relevant weakness. J Gerontol Ser A 69:559–566CrossRefGoogle Scholar
  32. 32.
    Ibrahim K, May C, Patel HP, Baxter M, Sayer AA, Roberts H (2016) A feasibility study of implementing grip strength measurement into routine hospital practice (GRImP): study protocol. Pilot Feasibility Study 2:27CrossRefGoogle Scholar
  33. 33.
    Cesari M, Kritchevsky SB, Newman AB, Simonsick EM, Harris TB, Penninx BW, Brach JS, Tylavsky FA, Satterfield S, Bauer DC, Rubin SM, Visser M, Pahor M, for the Health ABC Study (2009) Added value of physical performance measures in predicting adverse health-related events: results from the Health, Aging, and Body Composition Study. J Am Geriatr Soc 57:251–259CrossRefGoogle Scholar
  34. 34.
    Castell M-V, Sanchez M, Julian R, Queipo R, Martin S, Otero A (2013) Frailty prevalence and slow walking speed in persons age 65 and older: implications for primary care. BMC Family Pract 14:86CrossRefGoogle Scholar
  35. 35.
    Hoy D, Geere JA, Davatchi F, Meggitt B, Barrero LH (2014) A time for action: opportunities for preventing the growing burden and disability from musucloskeletal conditions in low- and middle-income countries. Best Pract Res Clin Rheumatol 28:377–393CrossRefGoogle Scholar
  36. 36.
    World Health Organization (2015) Health and human rights. In: WHO (ed) GenevaGoogle Scholar
  37. 37.
    Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA (2001) Frailty in older adults: evidence for a phenotype. J Gerontol 56:M146–M157CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Medicine-Western HealthThe University of MelbourneSt AlbansAustralia
  2. 2.Australian Institute for Musculoskeletal Science (AIMSS)The University of Melbourne and Western HealthMelbourneAustralia
  3. 3.Deakin Biostatistics Unit, Faculty of HealthDeakin UniversityGeelongAustralia
  4. 4.Chiang Mai University Research Institute for Health SciencesChiang MaiThailand
  5. 5.Research Centre for Generational Health and AgeingUniversity of NewcastleNewcastleAustralia
  6. 6.World Health Organization (WHO) SAGEGenevaSwitzerland
  7. 7.Department of AnthropologyUniversity of OregonEugeneUSA
  8. 8.College of Population StudiesChulalongkorn UniversityBangkokThailand
  9. 9.Public Health Foundation of IndiaNew DelhiIndia
  10. 10.National Centre for Epidemiology and Population Health, Research School of Population HealthAustralian National UniversityCanberraAustralia
  11. 11.School of Medicine and Public Health, Faculty of Health and MedicineThe University of NewcastleNewcastleAustralia

Personalised recommendations