Age- and sex-specific muscle health cut-offs improve prognostic accuracy in older patients with heart failure: a secondary analysis of a nationwide, multicenter cohort registry.
Aims Universal muscle health cut-offs for older patients with heart failure often overlook age- and sex-specific biological heterogeneity, potentially compromising prognostic accuracy. We aimed to develop and validate age- and sex-specific cut-off values for muscle health metrics to enhance prognost...
| Publicado en: | Age & Ageing Vol. 55; no. 2; pp. 1 - 12 |
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| Autores principales: | , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Feb2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=192513162&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 192513162 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Feb2026 vid: 55 iid: 2 pid: 622 pub: Oxford University Press / USA artinfo: ui: 192513162 10.1093/ageing/afag034 ppf: 1 ppct: 11 formats: tig: atl: Age- and sex-specific muscle health cut-offs improve prognostic accuracy in older patients with heart failure: a secondary analysis of a nationwide, multicenter cohort registry. aug: au: Miki, Yasuhiro Katano, Satoshi Nakagama, Takashi Iwata, Kentaro Kono, Yuji Sakurada, Koji Morisawa, Tomoyuki Kamiya, Kentaro Takahashi, Tetsuya affil: Committee of the J-Proof HF Registry, Japanese Society of Cardiovascular Physical Therapy, Tokyo, Japan su: Japan Sex distribution Age distribution Hospital care of older people Old age Hand physiology Mortality risk factors Reference values Risk assessment Predictive tests Skeletal muscle Secondary analysis Data analysis Receiver operating characteristic curves Research evaluation Heart failure Reporting of diseases Longitudinal method Kaplan-Meier estimator Log-rank test Geriatric assessment Research Research methodology Statistics Comparative studies Walking speed Individualized medicine Data analysis software Sarcopenia Sensitivity & specificity (Statistics) Grip strength Proportional hazards models Evaluation sug: subj: Sex distribution Age distribution Hospital care of older people Old age Japan Hand physiology Mortality risk factors Reference values Risk assessment Predictive tests Skeletal muscle Secondary analysis Data analysis Receiver operating characteristic curves Research evaluation Heart failure Reporting of diseases Longitudinal method Kaplan-Meier estimator Log-rank test Geriatric assessment Research Research methodology Statistics Comparative studies Walking speed Individualized medicine Data analysis software Sarcopenia Sensitivity & specificity (Statistics) Grip strength Proportional hazards models Evaluation keyword: copyrightHolder:British Geriatrics Society copyrightYear:2026 demography heart failure https://dx.doi.org/10.1093/ageing/afag034 inLanguage:en mortality muscle health metrics older adult older people patient prognosis physical therapy publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/41719426/ secondary data analysis short physical performance battery stratification walking speed copyrightHolder:British Geriatrics Society copyrightYear:2026 demography heart failure https://dx.doi.org/10.1093/ageing/afag034 inLanguage:en mortality muscle health metrics older adult older people patient prognosis physical therapy publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/41719426/ secondary data analysis short physical performance battery stratification walking speed ab: Aims Universal muscle health cut-offs for older patients with heart failure often overlook age- and sex-specific biological heterogeneity, potentially compromising prognostic accuracy. We aimed to develop and validate age- and sex-specific cut-off values for muscle health metrics to enhance prognostic performance. Methods and results From a nationwide, multicenter cohort registry, 9693 patients aged ≥65 years hospitalised for heart failure were analysed. We assessed five muscle health metrics (arm and calf circumference, handgrip strength, gait speed and Short Physical Performance Battery) and derived age- and sex-specific cut-off values for predicting 1-year all-cause mortality across three age groups (65–74, 75–84, 85+ years). Age- and sex-specific thresholds varied substantially across demographics (e.g. handgrip strength: 24.5–19.6 kg in men and 16.6–11.6 kg in women from the youngest to the oldest group) and showed robust prognostic associations with mortality (adjusted hazard ratio: 1.44–3.25, all P < .001). Importantly, age- and sex-specific cut-offs consistently outperformed fixed criteria by Asian Working Group for Sarcopenia in 2019, evidenced by substantial improvements in Akaike information criterion that ranged from 8.1 to 119.4, continuous net reclassification improvement (0.050 to 0.342), and integrated discrimination improvement (0.002 to 0.023) across four metrics. Conclusion Age- and sex-specific muscle health thresholds offer superior prognostic accuracy over universal fixed values in older patients with heart failure, evidenced by substantial improvements in model fit, reclassification and discrimination. This individualised approach enables more precise risk stratification and supports the transition toward personalised assessment in geriatric heart failure care. Data source registration University Hospital Medical Information Network Clinical Trials Registry, URL: https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr%5fview.cgi?recptno=R000054579 , Registration number: UMIN000047893. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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