Performance of the EWGSOP2 Cut-Points of Low Grip Strength for Identifying Sarcopenia and Frailty Phenotype: A Cross-Sectional Study in Older Inpatients

Abstract

Background: The European Working Group on Sarcopenia has recently proposed revised cut-off values for the definition of low grip strength (EWGSOP2). We therefore compared performance of the EWGSOP2 cut-off definition of low grip strength with other internationally used cut-off points in a sample of older patients. Methods: We analyzed geriatric assessment data in a cross-sectional sample of 98 older patients admitted to a post-acute care hospital. First, we compared prevalence of sarcopenia and frailty phenotype in our sample using low grip strength cut-points from the EWGSOP2 and seven other internationally used consensus statements. Second, we calculated correlations between low grip strength and two independent surrogate outcomes (i.e., gait speed, and the clinical frailty scale) for the EWGSOP2 and the other seven cut-point definitions. Results: Prevalence of sarcopenia based on the EWGSOP2 grip strength cut-off values was significantly lower (10.2%) than five of the seven other cut-point definitions (e.g., 19.4% based on Sarcopenia Definitions and Outcomes Consortium (SDOC) criteria). Similarly, frailty phenotype prevalence was significantly lower based on EWGSOP2 cut-points (57.1%) as compared to SDOC (70.4%). The correlation coefficient of gait speed with low grip strength based on EWGSOP2 cut-points was lower (0.145) as compared to other criteria (e.g., SDOC 0.240). Conclusions: Sarcopenia and frailty phenotype were identified considerably less using the EWGSOP2 cut-points for low grip strength, potentially underestimating prevalence of sarcopenia and frailty phenotype in post-acute hospital patients.

Impact of Using Population-Specific Cut-Points, Self-Reported Health, and Socio-Economic Parameters to Predict Sarcopenia: A Cross-Sectional Study in Community-Dwelling Kosovans Aged 60 Years and Older

“…Reis et al [ 34 ] were among the first to analyze the consequences of applying the new EWGSOP2 guideline instead of the former EWGSOP1 for sarcopenia case finding in older geriatric inpatients and described a substantial mismatch with a significant lowering of the number of men diagnosed with sarcopenia. The discord in prevalence from the lower numbers of the EWGSOP2 have been further explored and reported by other studies [ 35 , 36 , 37 , 39 , 40 , 41 ]. Besides the several distinguished differences between the two versions (lowering the diagnostic thresholds for isometric handgrip strength and muscle mass, the introduction of new suggested measurement methods for muscle strength, etc.…”

“…Furthermore, it has been suggested that until this global consensus is reached, prevalence data should be reported and interpreted within its own context [ 33 ]. Upon the publication of the revised EWGSOP2 consensus criteria [ 3 ], potentially different outcomes when comparing previous criteria have been investigated [ 34 , 35 , 36 , 37 , 38 , 39 ]. Reis et al [ 34 ] were among the first to analyze the consequences of applying the new EWGSOP2 guideline instead of the former EWGSOP1 for sarcopenia case finding in older geriatric inpatients and described a substantial mismatch with a significant lowering of the number of men diagnosed with sarcopenia.…”

Recent sarcopenia definitions—prevalence, agreement and mortality associations among men: Findings from population‐based cohorts

“…However, in contrast to our study, low strength was characterized as having low grip strength or chair rise speed in the EWGSOP2 definition; this would result in a higher prevalence compared with the use of grip strength alone as a measure of strength. Prevalence of low grip strength using various thresholds was compared in a study comprising 98 men and women admitted to a geriatric rehabilitation hospital in Switzerland 28 . As expected, prevalence of low grip strength according to the EWGSOP2 threshold (10.2%) was considerably lower compared with the SDOC threshold (19.4%).…”

Muscle Weakness and Walking Slowness for the Identification of Sarcopenia in the Older Adults from Northern Brazil: A Cross-Sectional Study

“…The suggested use of muscle weakness or walking slowness for the identification of sarcopenia [ 22 , 50 , 54 ] raises the question of the possibility of agreement between the two for diagnosis, although the correlation appears to be weak between the values of these two criteria [ 55 ].…”