Table 3.
Reclassification of MrOS Participants After Addition of Baumgartner, Newman, IWG, EWGSOP or FNIH Definitions of Sarcopenia to a Simple Model with Age (for Recurrent falls, Functional limitations, and Mortality) or Age and Bone Mineral Density (for Hip Fractures)
| Baumgartner | Newman | IWG | EWG | FNIH Definition #1 | FNIH Definition #2 | ||
|---|---|---|---|---|---|---|---|
| Recurrent falls over 1 year | |||||||
|
| |||||||
| N=694 with eventb | Appropriately reclassified | 143 (21%) | 117 (17%) | 70 (10%) | 68 (10%) | 22 (3%) | 5 (1%) |
| Inappropriately reclassified | 61 (9%) | 66 (10%) | 298 (43%) | 298 (43%) | 101(15%) | 37 (5%) | |
| No change | 490 (71%) | 511 (74%) | 326 (47%) | 328 (47%) | 571(82%) | 652 (94%) | |
| NRI (95%CI), events | 0.12 (0.08, 0.16) | 0.07 (0.04, 0.11) | −0.33 (−0.38, −0.28) | −0.33 (−0.38, −0.28) | −0.11 (−0.14, −0.08) | −0.05 (−0.06, −0.03) | |
|
| |||||||
| N=5134 without eventc | Appropriately reclassified | 285 (6%) | 284 (6%) | 1934 (38%) | 1947(38%) | 416 (8%) | 154 (3%) |
| Inappropriately reclassified | 916 (18%) | 675 (13%) | 195 (4%) | 176(3%) | 61 (1%) | 12 (0%) | |
| No change | 3933 (77%) | 4175 (81%) | 3005 (59%) | 3011(59%) | 4657 (91%) | 4968 (97%) | |
| NRI (95%CI), non-events | −0.12 (−0.14, −0.11) | −0.08 (−0.09, −0.06) | 0.34 (0.32, 0.35) | 0.35 (0.33, 0.36) | 0.07 (0.06, 0.08) | 0.03 (0.02, 0.03) | |
|
| |||||||
| Overall NRI (95% CI) | 0% (−5%, 4%) | 0% (−4%, 4%) | 0.01 (−0.04, 0.06) | 0.01 (−0.04, 0.06) | −0.05 (−0.08, −0.01) | −0.02 (−0.04, 0.00) | |
|
| |||||||
| Hip fractures over 9.8 years | |||||||
|
| |||||||
| N=207 with event | Appropriately reclassified | 4 (2%) | 12 (6%) | 20 (10%) | 12 (6%) | 3 (1%) | 3 (1%) |
| Inappropriately reclassified | 3 (1%) | 5 (2%) | 41 (20%) | 11 (5%) | 2 (1%) | 12 (6%) | |
| No change | 200 (97%) | 190 (92%) | 146 (71%) | 184 (89%) | 202 (98%) | 192 (93%) | |
| NRI (95%CI), events | 0.00 (−0.02, 0.03) | 0.03 (0.0, 0.07) | −0.10 (−0.17, −0.03) | 0.00 (−0.04, 0.05) | 0.00 (−0.02, 0.03) | −0.04 (−0.08, −0.01) | |
|
| |||||||
| N=5727 without event | Appropriately reclassified | 39 (1%) | 159 (3%) | 497 (9%) | 175 (3%) | 39 (1%) | 197 (3%) |
| Inappropriately reclassified | 41 (1%) | 180 (3%) | 231 (4%) | 132 (2%) | 38 (1%) | 47 (1%) | |
| No change | 5647 (99%) | 5388 (94%) | 4999 (87%) | 5420 (95%) | 5650 (99%) | 5483 (96%) | |
| NRI (95%CI), non-events | 0.00 (0.00, 0.00) | 0.00 (−0.01, 0.00) | 0.05 (0.04, 0.06) | 0.01 (0.00, 0.01) | 0.00 (0.00, 0.00) | 0.03 (0.02, 0.03) | |
|
| |||||||
| Overall NRI (95% CI) | 0.00 (0.02, 0.03) | 0.03 (−0.01, 0.07) | −0.06 (−0.13, 0.02) | 0.01 (−0.03, 0.06) | 0.01 (−0.02, 0.03) | −0.02 (−0.05, 0.02) | |
|
| |||||||
| Functional limitations over 4.6 years | |||||||
|
| |||||||
| N=590 with event | Appropriately reclassified | 38 (6%) | 133 (23%) | 28 (5%) | 31 (5%) | 6 (1%) | N/Aa |
| Inappropriately reclassified | 0 (0%) | 236 (40%) | 181 (31%) | 242 (41%) | 0 (0%) | ||
| No change | 552 (94%) | 221 (37%) | 381 (65%) | 317 (54%) | 584 (99%) | ||
| NRI (95%CI), events | 0.06 (0.04, 0.08) | −0.17 (−0.24, −0.11) | −0.26 (−0.30, −0.22) | −0.36 (−0.40, −0.31) | 0.01 (0.00, 0.02) | ||
|
| |||||||
| N=3136 without event | Appropriately reclassified | 1 (0%) | 982 (31%) | 581 (19%) | 807 (26%) | 0 (0%) | |
| Inappropriately reclassified | 147 (5%) | 495 (16%) | 51 (2%) | 46 (1%) | 20 (1%) | ||
| No change | 2988 (95%) | 1659 (53%) | 2504 (80%) | 2283 (73%) | 3116 (99%) | ||
| NRI (95%CI), non-events | −0.05 (−0.05, −0.04) | 0.16 (0.13, 0.18) | 0.17 (0.15, 0.18) | 0.24 (0.23, 0.26) | −0.01 (−0.01, 0.00) | ||
|
| |||||||
| Overall NRI (95% CI) | 0.02 (0.00, 0.04) | −0.02 (−0.09, 0.05) | −0.09 (−0.14, −0.04) | −0.11 (−0.16, −0.07) | 0.00 (0.00, 0.01) | ||
|
| |||||||
| Deaths over 9.8 years | |||||||
|
| |||||||
| N=2003 with event | Appropriately reclassified | 543 (27%) | 474 (24%) | 193 (10%) | 192 (10%) | 58 (3%) | 22 (1%) |
| Inappropriately reclassified | 938 (47%) | 930 (46%) | 1001 (50%) | 1009 (50%) | 602 (30%) | 377 (19%) | |
| No change | 522 (26%) | 599 (30%) | 809 (40%) | 802 (40%) | 1343 (67%) | 1604 (80%) | |
| NRI (95%CI), events | −0.20 (−0.23, −0.16) | −0.23 (−0.26, −0.19) | −0.40 (−0.43, −0.38) | −0.41 (−0.44 −0.38) | −0.27 (−0.29, −0.25) | −0.18 (−0.20, −0.16) | |
|
| |||||||
| N=3866 without event | Appropriately reclassified | 2220 (57%) | 2109 (55%) | 1392 (36%) | 1382 (36%) | 811(21%) | 306 (8%) |
| Inappropriately reclassified | 687 (18%) | 646 (17%) | 393 (10%) | 420 (11%) | 45 (1%) | 103 (3%) | |
| No change | 959 (25%) | 1111 (29%) | 2081 (54%) | 2064 (53%) | 3010 (78%) | 3457 (89%) | |
| NRI (95%CI), non-events | 0.40 (0.37, 0.42) | 0.38 (0.35, 0.40) | 0.26 (0.24, 0.28) | 0.25 (0.23, 0.27) | 0.20 (0.19, 0.21) | 0.05 (0.04, 0.06) | |
|
| |||||||
| Overall NRI (95% CI) | 0.20 (0.16, 0.24) | 0.15 (0.11, 0.19) | −0.15 (−0.18, −0.11) | −0.16 (−0.19, −0.12) | −0.07 (−0.10, −0.05) | −0.13 (−0.15, −0.10) | |
There were no incident functional limitations in men who met the FNIH definition #2, so these models could not be run.
Bold text indicates p<0.05.
For events, appropriate reclassification occurs when estimated risk increases when the additional factor is added to the model; inappropriate reclassification occurs when estimated risk decreases when the additional factor is added to the model.
For non-events, appropriate reclassification occurs when estimated risk decreases when the additional factor is added to the model; inappropriate reclassification occurs when estimated risk increases when the additional factor is added to the model.
IWG: presence of slowness (gait<1.0 m/s) and low lean mass (ALM/ht2≤7.23 kg/m2)
EWGSOP: presence of slowness (gait ≤0.8 m/s) plus low lean mass (ALM/ht2≤7.23 kg/m2) or weakness (grip<30 kg)
FNIH definition #1: Presence of both weakness (grip<26 kg) and low lean mass (ALM/BMI<0.789)
FNIH definition #2: Presence of slowness (gait≤0.8 m/s), weakness (grip<26 kg) and low lean mass (ALM/BMI<0.789)
IWG = International Working Group; EWGSOP = European Working Group for Sarcopenia in Older Persons, FNIH = Foundation for NIH Sarcopenia Project, ALM=appendicular lean mass, BMI = body mass index, NRI = net reclassification improvement.