Association between the muscle mass index and physical frailty in geriatric outpatients

Objective: Frailty syndrome is commonly seen in geriatric patients. In this study, we investigated the association between the muscle mass index and physical frailty in elderly outpatients. Materials and Methods: A cross-sectional study was conducted among elderly patients (≥60 years old) from the Geriatric Clinic of the Dr. Cipto Mangunkusumo Hospital in Jakarta, Indonesia, from April to June 2018. Each subject underwent anthropometric measurements, a frailty evaluation using the Cardiovascular Health Study questionnaire, and lean mass measurements using dual-energy X-ray absorptiometry. The appendicular lean mass (ALM) measurement was adjusted by the height squared (ALM/ht²) and by the body mass index (ALM/BMI) to indicate the muscle mass index. Results: The proportions of the frail, prefrail, and robust patients were 29.17%, 58.33%, and 12.5%, respectively. There was a significant difference in the ALM/ht² values between the frail and nonfrail (prefrail and robust) patients (6.54 [1.01] kg/m² vs. 7.03 [0.91] kg/m², P = 0.01), but not in the ALM/BMI values. No significant association was observed between frailty and the muscle mass index. Multivariate analysis indicated that the frailty status was significantly associated with the nutritional status (odds ratio [OR] = 3.67, 95% confidence interval [CI] = 1.59-8.49) and functional status (OR = 4.94, 95% CI = 2.01-11.75). Conclusion: Physical frailty was not significantly associated with the muscle mass index, but it was associated with the nutritional and functional statuses.