Abstract
BACKGROUND: While a recent meta-analysis of observational studies reported a statistically significant association between sarcopenia and both all-cause mortality and functional decline, a recently developed inverse heterogeneity (IVhet) model has been shown to be more valid than the traditional random-effects model used. OBJECTIVE: The objective of this short report was to use a previous meta-analysis to compare the two approaches. METHODS: Aggregate data meta-analysis of prospective observational studies conducted in any setting. Men and women 60years of age and older in which all-cause mortality (12 studies, 14,169 participants) or functional decline (6 studies, 8561 participants) was assessed. Using the IVhet model, pooling of previous studies regarding the association between sarcopenia and all-cause mortality as well as functional decline. Absolute and relative differences between IVhet and random-effects results were also calculated as well as influence analysis with each study deleted once. Non-overlapping 95% confidence intervals (CI) for odds ratios (OR) were considered statistically significant. RESULTS: Sarcopenia was associated with an increased risk for all-cause mortality (OR=3.64, 95% CI=2.94 to 4.51) and functional decline (OR=2.58, 95% CI=1.33 to 4.99). Compared to the random-effects model, the OR was slightly higher (0.04 or 1.1%) but with wider CI (0.16 or 11.3%) for all-cause mortality and 0.45 (14.9%) lower with a CI that was 0.34 (10.2%) wider for functional decline. With each study deleted from the model once, results remained statistically significant for both all-cause mortality and functional decline. CONCLUSION: These results provide additional and more accurate evidence in support of an association between sarcopenia and an increased risk for both all-cause mortality and functional decline.