“…In fact, this study indicated that low lean mass in women was not associated with elevated mortality rates. (McLean, Shardell, Alley, Cawthon, Fragala, Harris, Kenny, Peters, Ferrucci, Guralnik, Kritchevsky, Kiel, Vassileva, Xue, Perera, Studenski, and Dam 2014) This suggests that at some level, there is a disconnect between muscle mass and weakness that may theoretically be explained by other factors such as age-dependent inter- and intramuscular fat infiltration (Goodpaster, Carlson, Visser, Kelley, Scherzinger, Harris, Stamm, and Newman 2001;Visser, Kritchevsky, Goodpaster, Newman, Nevitt, Stamm, and Harris 2002), excitation-contraction coupling, (Delbono 2000) or dysfunctions of the central nervous system or neuromuscular junctions. (Vandervoort 2002) In support of this, evidence suggests that neither the measurement of muscle mass nor muscle index (appendicular lean mass relative to BMI) is consistently associated with adverse outcomes.…”