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Risk of All-Cause Mortality in Different Muscle Health States Among Community-Dwelling Older Adults
Yi-Hsueh Liao1, Tao-Chun Peng2, Yuan-Ping Chao2
1Department of Family Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan (R.O.C.); Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (R.O.C.).
Objectives:
Although muscle health is increasingly recognized as a critical determinant of mortality in ageing populations, existing research has largely concentrated on singular conditions such as sarcopenia or dynapenia. Comparative analyses across a spectrum of muscle health phenotypes are limited. This study investigates the differential mortality risks associated with combined muscle quantity and quality profiles, highlighting potential sex-specific disparities in older individuals residing in community settings.
Design:
Prospective study.
Participants And Setting:
Individuals aged 65 years and older dwelling in the community who underwent routine health checkups were recruited in northern Taiwan, between 2015 and 2021.
Methods:
Muscle mass, handgrip strength, and walking speed were assessed to stratify participants into 4 categories: robust, dynapenia, presarcopenia, and sarcopenia. All-cause mortality was ascertained through linkage with the national death registry up to December 2021. Cox proportional hazards models were conducted with sex-stratified analyses and sequential adjustment to estimate mortality risk across different phenotypes of muscle health.
Results:
Of 1194 older adults (median follow-up 54.8 months), 678 (56.78%) were women; 27.9% had dynapenia and 17.7% sarcopenia. Fifty-two participants (4.35%) had died during the study period. The dynapenia group had the highest comorbidity burden and adverse metabolic profiles. Higher gait speed and handgrip strength were inversely correlated with mortality in both sexes, whereas low skeletal muscle mass was predictive only in older women. Sarcopenia in female participants [adjusted hazard ratio (HR) 4.89, 95% CI 1.08-22.21] and dynapenia in men (adjusted HR 3.57, 95% CI 1.10-11.63) corresponded with a notable rise in mortality risk.
Conclusions And Implications:
Dynapenia in older men and sarcopenia in older women were independently associated with mortality, highlighting sex-sensitive prognostic differences and underscoring the need of phenotype-specific strategies for healthy ageing.
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