Correlation of frailty severity with muscle mass and physical function in Chinese older adults:preliminary findings / 中华老年医学杂志

ABSTRACT

Objective To explore the relationship between the severity of frailty and muscle mass/function in older people,and to determine whether and/or how the results would be influenced by the assessment method for frailty.Methods A total of 106 older adults aged 63-95 years were recruited from individuals undergoing regular health examinations at the Outpatient Department of Beijing Hospital.The characteristics of participants were collected through a questionnaire and subsequently evaluated.Frailty was assessed by both the Fried phenotype and an index of accumulated deficits (FI).Sarcopenia was identified based on the criteria of the Asian Working Group for Sarcopenia (AWGS).Average skeletal muscle mass,appendicular skeletal muscle mass and the appendicular skeletal muscle index (ASMI) were measured by bioelectrical impedance analysis (BIA).Furthermore,grip strength,the 4 m walking test,the timed up and go test (TUGT),the five times sit to stand test (FTSST),and the balance test were performed to investigate the physical performance.Results There were 15 (14.2％) frail and 65 (61.3％) pre-frail cases in this group.Poor grip strength 59 (55.7％) and slow gait speed 33 (31.1％) were more prevalent in frail older people.Meanwhile,when the phenotypic definition of frailty was used,muscle mass and ASMI decreased as the severity of frailty increased (F=6.579,3.969,4.507,respectively;all P＜0.05).Frail older people had significantly slower gait speed and poorer grip strength than those who were not frail (F=23.897,4.583,respectively;both P＜0.05).Moreover,frail older people were more likely to be sarcopenia (53.5％) than those who were pre frail (30.8％) or not frail (3.8％).Participants with frailty performed worse on FTSST,TUGT and the balance test (all P＜0.05) and had markedly lower levels of FI (0.15±0.04,0.18±0.06,and 0.28±0.09,respectively;F=21.764,P＜0.05) than those in the pre-frail and non-frail groups.Appendicular skeletal muscle mass,skeletal muscle mass,grip strength and walking speed were negatively correlated with FI (r =-0.256,-0.321,-0.343,-0.374,respectively;all P＜0.05) while ASMI showed no statistical correlation with FI (P＞0.05).Conclusions Poor grip strength and slow gait speed are very common in frail older people.There is a close correlation between muscle mass/function and frailty.The degree of association of frailty severity with physical performance remains largely unchanged regardless of what assessment method is used.