A rapid point-of-care ultrasound marker for muscle mass and muscle strength in older adults

Abstract

Background/Objectives Sarcopenia is defined as the gradual age-associated loss of both muscle quantity and strength in older adults, and is associated with increased mortality, falls, fractures and hospitalisations. Current sarcopenia criteria use dual-energy X-ray absorptiometry (DXA) measures of muscle mass, a test that cannot be performed at the bedside, unlike point-of-care ultrasound (PoCUS). We examined the association between ultrasonic measures of muscle thickness (MT, vastus medialis muscle thickness) and measures of muscle quantity and strength in older adults. Methods A total of 150 older adults (age ≥ 65; mean age 80.0 ± 0.5 years, 66 women, 84 men) were recruited sequentially from geriatric medicine clinics. Each subject had lean body mass (LBM, by bioimpedance assay), grip strength, mid-arm biceps circumference (MABC), gait speed and MT measured. All initial models were adjusted for biological sex. Results In our final parsimonious models, MT showed a strong significant correlation with all measures of muscle mass, including LBM (Standardised β = 0.204 ± 0.058, R2 = 0.577, P < 0.001) and MABC (Standardised β = 0.141 ± 0.067, R2 = 0.417, P = 0.038). With respect to measures of muscle quality, there was a strong significant correlation with grip strength (Standardised β = 0.118 ± 0.115, R2 = 0.511, P < 0.001) but not with subject performance (gait speed). Conclusions MT showed strong correlations with both measures of muscle mass (LBM and MABC) and with muscle strength (grip strength). Although more work needs to be done, PoCUS shows potential as a screening tool for sarcopenia in older adults.

Application of Muscle Thickness and Quality Measured by Ultrasound in Frailty Assessment in China

“…At present, the muscle thickness measured by ultrasound has a good correlation with the muscle mass measured by dual-energy X-ray absorption as the gold standard ( 17 , 18 ). More importantly, the advantage of ultrasound lies not only in the evaluation of muscle mass in various parts of the body but also in the accurate detection of muscle quality ( 19 ).…”

Muscle Evaluation and Hospital-Associated Disability in Acute Hospitalized Older Adults

“…The number of participants was 256, after excluding cases of in-hospital death (n=20), transfer to another department (n=6), and a missing value of the BI (n=18). The median length of hospital stay was 17 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). Table 1 shows the background characteristics of the participants at admission.…”

“…Table 1 shows the background characteristics of the participants at admission. The mean age was 85.2 ± 5.9 years, the percentage of men was 41.8%, the median MMSE value was 21 (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26), the median CCI value was 2 (1-3), the mean MNA-SF was 8.6 ± 3.4, and the median BI was 85 (51.3-100).…”

“…Muscle ultrasound of the quadriceps femoris has recently been found useful for evaluating muscle morphology and muscle quality (12). The muscle thickness of the quadriceps femoris shows strong correlations with muscle mass (13), and echo intensity (EI) is an indicator of skeletal muscle quality (14). Muscle ultrasound has been performed in clinical practice to diagnose sarcopenia (15) and to predict mortality (16), and worse recovery of ADLs (17).…”

Association between Masseter Muscle Area and Thickness and Outcome after Carotid Endarterectomy: A Retrospective Cohort Study

“…Due to the superficial anatomical position of the masseter muscle, thickness could also be assessed by using point of care ultrasound (POCUS) [ 19 ]. POCUS could be used as a simple bedside tool to assess the masseter muscle thickness, and it could be a useful method to screen for low muscle mass in patients without a CT scan [ 32 , 33 ]. However, although POCUS could be used as a simple bedside tool, it could be considered as more cumbersome to use in the daily clinical practice, compared with BMI and frailty indices.…”