How does the cut-off point for grip strength affect the prevalence of sarcopenia and associated factors? Findings from the ELSI-Brazil Study.

This study aimed to compare the prevalence of sarcopenia and associated factors with the definition of muscle weakness established using two different cut-off points for grip strength. We carried out a cross-sectional study with 7,065 participants (aged 50 or older) from the ELSI-Brazil Study. Sarcopenia was defined by the European Working Group on Sarcopenia in Older People (EWGSOP2) and two different cut-off points for grip strength to define weakness: < 27kg for men/< 16kg for women or < 36kg for men < 23kg for women. The prevalence of different sarcopenia status was estimated, and associations with sociodemographic, behavioral, and clinical factors were investigated using multinomial regression models. The mean age of participants was 61 years; 51.8% were women and 41.5% were at risk of malnutrition. By adopting the higher cut-off points (< 36kg/< 23kg) for the definition of weakness, the prevalence of probable sarcopenia and sarcopenia quadrupled (40.1% versus 10.6%; 5% versus 1.4%, respectively) and the prevalence of severe sarcopenia doubled (8.8 versus 3.9%). Nutritional status was associated with sarcopenia status, however the cut-off points < 36/< 23kg increased substantially the relative risk ratio between malnutrition and severe sarcopenia (RRR = 11.23 versus 6.45). In general, factors associated with sarcopenia status were similar irrespective of the cut-off point adopted. Higher cut-off points for the definition of weakness may be better for identifying sarcopenia, enabling early interventions to avoid adverse outcomes related to the disease.