Sarcopenia in Peripheral Arterial Disease: Prevalence and Effect on Functional Status
Odessa Addison, Steven J Prior, Rishi Kundi, Monica C Serra, Leslie I Katzel, Andrew W Gardner, Alice S Ryan, Odessa Addison, Steven J Prior, Rishi Kundi, Monica C Serra, Leslie I Katzel, Andrew W Gardner, Alice S Ryan
Abstract
Objectives: (1) To determine the prevalence of sarcopenia in older men with peripheral arterial disease (PAD); (2) to compare a subgroup of the group with age-, race-, sex-, and body mass index (BMI)-matched non-PAD control counterparts, and (3) to compare the functional status of those with PAD with and without sarcopenia.
Design: Cohort study.
Setting: Medical center.
Participants: Sedentary community-dwelling men (N=108; age, >50y) with a confirmed diagnosis of PAD (44% blacks; BMI, 27.8±0.4kg/m2; ankle-brachial index, .62±.01).
Interventions: Not applicable.
Main outcome measures: Dual-energy x-ray absorptiometry scans were used to assess appendicular lean mass and determine the prevalence of sarcopenia by/height2. Treadmill tests were used to determine claudication onset time, peak walking time, and claudication recovery time. 6-Minute walk distance was also measured.
Results: Sarcopenia prevalence in our PAD cohort was 25%. The PAD subgroup (n=42) matched with control counterparts in terms of race, sex, age, and BMI had higher prevalence rates than did their non-PAD counterparts (23.8% vs 2.4%; P<.05). Individuals with sarcopenia (n=28) had a shorter 6-minute walk distance (326±18.8m vs 380±9.7m; P<.05) and higher claudication recovery time (592±98s vs 395±29s; P<.05) than did individuals with PAD but without sarcopenia (n=80). There was no difference in claudication onset time or peak walking time between the PAD groups.
Conclusions: Men with PAD demonstrate a high prevalence of sarcopenia. Those with sarcopenia and PAD demonstrate decreased mobility function.
Keywords: Muscles; Peripheral arterial disease; Rehabilitation; Sarcopenia.
Conflict of interest statement
The authors declare no conflict of interest
Published by Elsevier Inc.
Figures
References
- von Haehling S, Morley JE, Anker SD. An overview of sarcopenia: facts and numbers on prevalence and clinical impact. J Cachexia Sarcopenia Muscle. 2010;1:129–33.
- Morley JE. Sarcopenia: diagnosis and treatment. J Nutr Health Aging. 2008;12:452–6.
- Landi F, Liperoti R, Fusco D, et al. Prevalence and risk factors of sarcopenia among nursing home older residents. J Gerontol A Biol Sci Med Sci. 2012;67:48–55.
- Fielding RA, Vellas B, Evans WJ, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011;12:249–56.
- Woo T, Yu S, Visvanathan R. Systematic Literature Review on the Relationship Between Biomarkers of Sarcopenia and Quality of Life in Older People. J Frailty Aging. 2016;5:88–99.
- Landi F, Liperoti R, Fusco D, et al. Sarcopenia and mortality among older nursing home residents. J Am Med Dir Assoc. 2012;13:121–6.
- Janssen I, Shepard DS, Katzmarzyk PT, Roubenoff R. The healthcare costs of sarcopenia in the United States. J Am Geriatr Soc. 2004;52:80–5.
- Cruz-Jentoft AJ, Landi F, Topinkova E, Michel JP. Understanding sarcopenia as a geriatric syndrome. Curr Opin Clin Nutr Metab Care. 2010;13:1–7.
- Collins TC, Petersen NJ, Suarez-Almazor M, Ashton CM. The prevalence of peripheral arterial disease in a racially diverse population. Arch Intern Med. 2003;163:1469–74.
- Mozaffarian D, Benjamin EJ, Go AS, et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2016;133:e38–60.
- McDermott MM, Greenland P, Liu K, et al. Leg symptoms in peripheral arterial disease: associated clinical characteristics and functional impairment. JAMA. 2001;286:1599–606.
- McDermott MM, Criqui MH, Greenland P, et al. Leg strength in peripheral arterial disease: associations with disease severity and lower-extremity performance. J Vasc Surg. 2004;39:523–30.
- McDermott MM, Ferrucci L, Guralnik J, et al. Pathophysiological changes in calf muscle predict mobility loss at 2-year follow-up in men and women with peripheral arterial disease. Circulation. 2009;120:1048–55.
- McDermott MM, Guralnik JM, Ferrucci L, et al. Physical activity, walking exercise, and calf skeletal muscle characteristics in patients with peripheral arterial disease. J Vasc Surg. 2007;46:87–93.
- McDermott MM, Liu K, Tian L, et al. Calf muscle characteristics, strength measures, and mortality in peripheral arterial disease: a longitudinal study. J Am Coll Cardiol. 2012;59:1159–67.
- McDermott MM. Functional impairment in peripheral artery disease and how to improve it in 2013. Curr Cardiol Rep. 2013;15:347.
- McDermott MM, Greenland P, Liu K, et al. The ankle brachial index is associated with leg function and physical activity: the Walking and Leg Circulation Study. Ann Intern Med. 2002;136:873–83.
- Aboyans V, Criqui MH, Abraham P, et al. Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart Association. Circulation. 2012;126:2890–909.
- Baumgartner RN, Koehler KM, Gallagher D, et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol. 1998;147:755–63.
- Ryan AS, Ivey FM, Serra MC, Hartstein J, Hafer-Macko CE. Sarcopenia and Physical Function in Middle-Aged and Older Stroke Survivors. Arch Phys Med Rehabil. 2016
- Prior SJ, Ryan AS, Blumenthal JB, Watson JM, Katzel LI, Goldberg AP. Sarcopenia Is Associated With Lower Skeletal Muscle Capillarization and Exercise Capacity in Older Adults. J Gerontol A Biol Sci Med Sci. 2016;71:1096–101.
- Gardner AW, Katzel LI, Sorkin JD, et al. Improved functional outcomes following exercise rehabilitation in patients with intermittent claudication. J Gerontol A Biol Sci Med Sci. 2000;55:M570–7.
- Montgomery PS, Gardner AW. The clinical utility of a six-minute walk test in peripheral arterial occlusive disease patients. J Am Geriatr Soc. 1998;46:706–11.
- McDermott MM, Ades P, Guralnik JM, et al. Treadmill exercise and resistance training in patients with peripheral arterial disease with and without intermittent claudication: a randomized controlled trial. JAMA. 2009;301:165–74.
- Regensteiner J, Steiner J, Panzer R. Evaluation of walking impairment by questionnaire in patients with peripheral arterial disease. J Vasc Med Bio. 1990;2:142–52.
- Lera L, Albala C, Sanchez H, et al. Prevalence of Sarcopenia in Community-Dwelling Chilean Elders According to an Adapted Version of the European Working Group on Sarcopenia in Older People (EWGSOP) Criteria. J Frailty Aging. 2017;6:12–7.
- Lee WJ, Liu LK, Peng LN, Lin MH, Chen LK, Group IR Comparisons of sarcopenia defined by IWGS and EWGSOP criteria among older people: results from the I-Lan longitudinal aging study. J Am Med Dir Assoc. 2013;14:528 e1–7.
- Legrand D, Vaes B, Mathei C, Swine C, Degryse JM. The prevalence of sarcopenia in very old individuals according to the European consensus definition: insights from the BELFRAIL study. Age Ageing. 2013;42:727–34.
- Lin CC, Lin WY, Meng NH, et al. Sarcopenia prevalence and associated factors in an elderly Taiwanese metropolitan population. J Am Geriatr Soc. 2013;61:459–62.
- Patel HP, Syddall HE, Jameson K, et al. Prevalence of sarcopenia in community-dwelling older people in the UK using the European Working Group on Sarcopenia in Older People (EWGSOP) definition: findings from the Hertfordshire Cohort Study (HCS) Age Ageing. 2013;42:378–84.
- Scott D, Hayes A, Sanders KM, Aitken D, Ebeling PR, Jones G. Operational definitions of sarcopenia and their associations with 5-year changes in falls risk in community-dwelling middle-aged and older adults. Osteoporos Int. 2014;25:187–93.
- Volpato S, Bianchi L, Cherubini A, et al. Prevalence and clinical correlates of sarcopenia in community-dwelling older people: application of the EWGSOP definition and diagnostic algorithm. J Gerontol A Biol Sci Med Sci. 2014;69:438–46.
- Yoshida D, Suzuki T, Shimada H, et al. Using two different algorithms to determine the prevalence of sarcopenia. Geriatr Gerontol Int. 2014;14(Suppl 1):46–51.
- Smoliner C, Sieber CC, Wirth R. Prevalence of sarcopenia in geriatric hospitalized patients. J Am Med Dir Assoc. 2014;15:267–72.
- Gardner AW, Forrester L, Smith GV. Altered gait profile in subjects with peripheral arterial disease. Vasc Med. 2001;6:31–4.
- Kuo HK, Yu YH. The relation of peripheral arterial disease to leg force, gait speed, and functional dependence among older adults. J Gerontol A Biol Sci Med Sci. 2008;63:384–90.
- Evans NS, Liu K, Criqui MH, et al. Associations of calf skeletal muscle characteristics and peripheral nerve function with self-perceived physical functioning and walking ability in persons with peripheral artery disease. Vasc Med. 2011;16:3–11.
- Hicks GE, Simonsick EM, Harris TB, et al. Trunk muscle composition as a predictor of reduced functional capacity in the health, aging and body composition study: the moderating role of back pain. J Gerontol A Biol Sci Med Sci. 2005;60:1420–4.
- Suri P, Kiely DK, Leveille SG, Frontera WR, Bean JF. Trunk muscle attributes are associated with balance and mobility in older adults: a pilot study. PM R. 2009;1:916–24.
- Casanova C, Celli BR, Barria P, et al. The 6-min walk distance in healthy subjects: reference standards from seven countries. Eur Respir J. 2011;37:150–6.
- Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther. 2002;82:128–37.
- Gardner AW, Womack CJ, Sieminski DJ, Montgomery PS, Killewich LA, Fonong T. Relationship between free-living daily physical activity and ambulatory measures in older claudicants. Angiology. 1998;49:327–37.
- Sieminski DJ, Gardner AW. The relationship between free-living daily physical activity and the severity of peripheral arterial occlusive disease. Vasc Med. 1997;2:286–91.
- Askew CD, Green S, Walker PJ, et al. Skeletal muscle phenotype is associated with exercise tolerance in patients with peripheral arterial disease. J Vasc Surg. 2005;41:802–7.
- Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39:412–23.
- McDermott MM, Liu K, Carroll TJ, et al. Superficial femoral artery plaque and functional performance in peripheral arterial disease: walking and leg circulation study (WALCS III) JACC Cardiovasc Imaging. 2011;4:730–9.
- Cruz-Jentoft AJ, Landi F, Schneider SM, et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS) Age Ageing. 2014;43:748–59.
Source: PubMed