BMC Med. 2026 Apr 6. doi: 10.1186/s12916-026-04829-5. Online ahead of print.
ABSTRACT
BACKGROUND: Sarcopenia, the age-related loss of skeletal muscle mass and function, has been linked to adverse health outcomes. Cross-sectional associations have been observed between skeletal and cardiac muscle mass and function in healthy, community-dwelling older adults during normative aging. Further longitudinal studies on the skeletal muscle-cardiac axis during aging are needed to inform the temporal patterns and impact of these associations.
METHODS: We analyzed data from participants from the Baltimore Longitudinal Study of Aging. Individual longitudinal rates of change (random slopes) of echocardiography-derived cardiac function, appendicular lean mass (ALM), and maximal handgrip strength (HGS) were estimated with linear mixed-effects models. The associations between baseline measurements and rates of change () were examined using Pearson correlation and multiple linear regression. Continuous variables are expressed as mean ± standard deviation (SD).
RESULTS: Among 1025 participants (66.6 ± 13.1 years, 47.8% male), the baseline mean HGS was 33.1 ± 11.0 kg, and ALM was 20.8 ± 5.3 kg; the mean left ventricular ejection fraction was 67.5 ± 9.7%, and LV mass (LVM) was 145.6 ± 50.4 g. With aging, HGS decreased by 0.36 kg/year (95% CI: -0.41, -0.31), ALM decreased by 25.1 g/year (95% CI: -34.7, -15.5), and LVM decreased by 0.730 g/year (95% CI: -0.998, -0.460). Both ALM and HGS were inversely correlated with advancing age ([r = -0.159 p < 0.001] and [r = -0.172 p < 0.001], respectively), while LVM was not (p = 0.178). Adjusting for baseline, ALM was significantly associated with LVM independently of age, sex, and LVM (β = 0.287, p < 0.001, adj. R2 = 0.663); the association persisted after adjustment for pulse pressure, mean arterial pressure, and body mass index. The interaction term sex*baseline-adjusted ALM was statistically significant (p < 0.050). ALM was also correlated with LVEF (r = 0.102, p = 0.001), while HGS was not significantly correlated with LVM (p = 0.642).
CONCLUSIONS: Among community-dwelling normative aging adults, age-associated decline in skeletal muscle mass correlated with reductions in LVM and function, independently of age, sex, and hemodynamic loading conditions. Our findings suggest a skeletal muscle-cardiac axis characterized by parallel declines beginning in early aging, preceding cardiovascular disease. Further studies exploring cardiac and skeletal muscle aging-related declines may direct interventions to halt these adverse processes concurrently.
PMID:41937125 | DOI:10.1186/s12916-026-04829-5