Addressing the Main Barrier to Sarcopenia Identification: Utility of Practical Office-Based Bioimpedance Tools Vs. Dual Energy X-ray Absorptiometry (DXA) Body Composition for Identification of Low Muscle Mass in Older Adults

Abstract

Background

Sarcopenia is associated with increased morbidity and mortality. Clinically, sarcopenia can be overlooked, especially in obesity. Sarcopenia diagnostic criteria includes muscle mass (MM) and function assessments. Muscle function can be readily assessed in a clinic setting (grip strength, chair stand test). However, MM requires dual energy Xray absorptiometry (DXA) Body Composition (BC) or other costly tools, not readily available.

Methods

Observational cohort study of independently mobile, community dwelling older adults, comparing MM using two office-based, direct-to-consumer bioimpedance (BIA) scales (Ozeri® and Omron®, differing by Omron® including hand sensors) to DXA. European Working Group on Sarcopenia in Older People (EWGSOP) DXA or BIA low MM diagnostic cut-offs were used to classify participants as having low or normal MM.

Results

Fifty participants: 11 men, 39 women. Forty-two completed DXA. Age 75.8yrs [67-90]. 81% obese based on body fat cut-offs. With DXA [ASM/height²], 15 had low MM. Using BIA [mmass/height²], 7 with Ozeri®, and 27 with Omron®, had low MM. Positive predictive value for low MM versus DXA (as the gold standard) for Ozeri® was 73.3% and Omron® was 92.8%. Good correlation between BIA scales and DXA for body fat estimates.

Conclusions

Omron® captured all low MM participants identified by DXA plus all on DXA diagnostic borderline. Prevalence of obesity was high. Sarcopenic obese the most difficult to identify clinically.  Low cost, readily available, direct-to-consumer BIA BC scales, especially with hand sensors, provide immediate, reliable information on muscle and fat mass. This can prompt appropriate investigation and/or intervention for sarcopenia or sarcopenic obesity.