BACKGROUND Sarcopenia is a risk-factor for all-cause mortality among older adults, but it is unknown if sarcopenia predisposes older adults to specific causes of death. Further, it is unknown if the prognostic role of sarcopenia differs between males and females, and obese and non-obese individuals. METHODS A population-based cohort study among 4425 older adults from the Third National Health and Nutrition Survey (1988-1994). Muscle mass was quantified using bioimpedance analysis, and muscle function was quantified using gait speed. Multivariable-adjusted Cox regression analysis examined the relationship between sarcopenia and mortality outcomes. RESULTS The mean age of study participants was 70.1 years. The prevalence of sarcopenia was 36.5%. Sarcopenia associated with an increased risk of all-cause mortality [hazard ratio (HR): 1.29 (95% confidence interval (95% CI): 1.13-1.47); P < 0.001] among males and females. Sarcopenia associated with an increased risk of cardiovascular-specific mortality among females [HR: 1.61 (95% CI: 1.22-2.12); P = 0.001], but not among males [HR: 1.07 (95% CI: 0.81-1.40; P = .643); P interaction = 0.079]. Sarcopenia was not associated with cancer-specific mortality among males and females [HR: 1.07 (95% CI: 0.78-1.89); P = 0.672]. Sarcopenia associated with an increased risk of mortality from other causes (i.e. non-cardiovascular and non-cancer) among males and females [HR: 1.32 (95% CI: 1.07-1.62); P = 0.008]. Obesity, defined using body mass index (P interaction = 0.817) or waist circumference (P interaction = 0.219) did not modify the relationship between sarcopenia and all-cause mortality. CONCLUSIONS Sarcopenia is a prevalent syndrome that is associated with premature mortality among community-dwelling older adults. The prognostic value of sarcopenia may vary by cause-specific mortality and differ between males and females.

中文翻译：

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基于社区的老年人样本中的肌肉减少症和死亡率。

背景肌少症是老年人全因死亡的危险因素，但尚不清楚肌少症是否会使老年人容易出现特定死因。此外，尚不清楚肌肉减少症的预后作用在男性和女性、肥胖和非肥胖个体之间是否有所不同。方法 对来自第三次全国健康和营养调查（1988-1994 年）的 4425 名老年人进行一项基于人群的队列研究。使用生物阻抗分析来量化肌肉质量，并使用步态速度来量化肌肉功能。多变量调整的 Cox 回归分析检查了肌肉减少症与死亡率结果之间的关系。结果 研究参与者的平均年龄为 70.1 岁。肌肉减少症的患病率为 36.5%。肌肉减少症与全因死亡风险增加相关[风险比 (HR)：1.29（95% 置信区间 (95% CI)：1.13-1.47）；P < 0.001] 男性和女性。肌肉减少症与女性心血管特异性死亡风险增加相关[HR：1.61（95% CI：1.22-2.12）；P = 0.001]，但不在男性中[HR：1.07（95% CI：0.81-1.40；P = .643）；P 相互作用 = 0.079]。肌肉减少症与男性和女性癌症特异性死亡率无关[HR：1.07（95% CI：0.78-1.89）；P = 0.672]。肌肉减少症与男性和女性其他原因（即非心血管和非癌症）死亡风险增加相关[HR：1.32（95% CI：1.07-1.62）；P = 0.008]。使用体重指数（P 相互作用 = 0.817）或腰围（P 相互作用 = 0.219）定义的肥胖并没有改变肌肉减少症与全因死亡率之间的关系。结论 肌肉减少症是一种普遍的综合征，与社区老年人过早死亡有关。肌肉减少症的预后价值可能因特定原因的死亡率而异，并且男性和女性之间也不同。