Phase Angle Cut-Off Points and Their Association With Sarcopenia and Frailty in Adults of 50–64 Years Old and Older Adults in Mexico City

Abstract

Background: In recent studies, the usefulness of the phase angle (PA) to assess geriatric conditions such as sarcopenia and frailty has been evaluated. However, there are no useful cut-off points for clinical research and/or practice.Objective: To analyze PA cut-off points associated with sarcopenia and frailty in adults of 50-64 years old and older adults in Mexico City.Design: Cross-sectional analysis of the FraDySMex cohort study (Frailty, Dynapenia, and Sarcopenia in Mexican Adults).Setting and Participants: 498 people were included, 78.7% women, aged 71.1 ± 9.5 years. Methods: The sarcopenia measurements were made according to the European Working Group on Sarcopenia in Older People (EWGSOP) (2019) (by dynamometer to evaluate hand grip strength and dual energy X-ray absorptiometry (DXA) for appendicular muscle mass), and the frailty through the physical frailty phenotype with cut-off points adjusted to the Mexican population. The PA was evaluated by bioelectrical impedance analysis (BIA), tetrapolar to 50 Hz, other variables such as socio-demographic, comorbidity, cognitive status, and functional dependence were evaluated.Results: The prevalence of frailty was 10.6% and sarcopenia 10.0%. The mean of the PA was 4.6° ± 0.70°. The PA cut-off point for frailty in adults 50 to 64 years was ≤4.3° [sensitivity (S) = 91.95%, specificity (Sp) 66.77%, AUROC (Area Under the Receiver Operating Characteristic) curve = 0.9273 95% CI (0.8720-0.9825)]; the PA cut-off point for sarcopenia was ≤4.3 [S = 91.95%, Sp = 66.77%, AUROC = 0.9306 95% CI (0.8508-1.000)]. The PA cut-off for frailty in adults ≥ 65 years was ≤4.1° [S = 72.37%, Sp 71.43%, AUROC = 0.7925 95%, CI (0.7280-0.8568)] for sarcopenia was ≤4.1° [S = 72.76%, Sp 73.81%, AUROC = 0.7930 95% CI (0.7272-0.8587)]. These cut-off points showed a significant association between PA with frailty (OR 4.84; 95% CI 2.61-8.99) and sarcopenia (OR 8.44; 95% CI 3.85-18.4) after adjusted by age, sex, BMI, comorbidity index and cognitive impairment.Conclusions and Implications: These cut-off points of PA could be useful for the screening of sarcopenia and frailty in Mexican adults of 50 years and older in centers that have BIA.

Role of phase angle in older adults with focus on the geriatric syndromes sarcopenia and frailty

“…In a nationally representative sample of the NHANES study of 4,667 older adults, men and women with phase angle values below the first quintile had a 3-fold higher risk of being frail [47]. In the FraDySMex cohort study (Frailty, Dynapenia, and Sarcopenia in Mexican Adults), low phase angle was associated with frailty, even after controlling for age, sex, BMI, and comorbidities [48]. Similarly, in a large cohort of community-dwelling old in Japan, a low phase angle was linked to frailty as well to overall morbidity and longer hospital stay as well as higher short term and one-year mortality [58].…”

Segmental Bioimpedance Variables in Association With Mild Cognitive Impairment

“…In terms of muscle quality, phase angle and ECW/ICW have been recommended as indicators of muscle quality ( 60 , 61 ). Phase angle is a major parameter previously investigated as a predictor of morbidity and mortality for several pathological conditions or critical illnesses, such as mortality in intensive care or in postoperative patients ( 62 – 64 ), sarcopenia, frailty ( 65 ), and Human Immunodeficiency Virus infection ( 66 ). It is also suggested as a potential indicator for diabetes ( 67 ), hyperlipidemia ( 68 ), and hypertension ( 69 ), which are known risk factors of cognitive impairment.…”

“…It is also suggested as a potential indicator for diabetes ( 67 ), hyperlipidemia ( 68 ), and hypertension ( 69 ), which are known risk factors of cognitive impairment. The phase angle cutoff threshold varies across samples of different ages, sexes, and morbidities ( 65 , 70 , 71 ). In this study, MCI patients of both sexes had just a slightly lower phase angle than the normal controls, and this difference disappeared after controlling for covariates in both women and men; the muscle quality expressed by phase angle might not be a sensitive marker of cognitive impairment in its early stage.…”

Sarcopenia: Technological Advances in Measurement and Rehabilitation

“…According to a study carried out in Mexico [33] on active older women, there seems to be no correlation between PhA and sarcopenia parameters, but PhA seems to be associated, with a doubtful biological meaning, with speed walking [33] (or PP). In a recent paper [34], they analyzed sarcopenia on the basis of the parameters defined by the second EWGSOP guidelines, and physical frailty, according to the parameters defined by Fried et al [8], both adjusted to the Mexican population.…”