Objective: Sarcopenia is a geriatric syndrome with a prevalence ranging from 5% to 50% in community-dwelling adults. It is associated with adverse outcomes including worse functional status, falls, and mortality. A paucity of studies have included an assessment of sarcopenia among older adults receiving in-hospital rehabilitation. This is, at least partially, due to the lack of simple assessment methods to reliably measure muscle mass. The objective of this study was to evaluate the probability of sarcopenia using a validated simple method and examine the association between sarcopenia and functional outcomes at discharge. Setting: One in-hospital rehabilitation setting. Design: Prospective cohort study. Participants: A total of 280 patients 65 years and older who were admitted to in-hospital rehabilitation. Measurements: The probability of sarcopenia was determined using a validated method that includes 3 variables: age, grip strength, and calf circumference. Two multivariable linear regression models were used to analyze the association between the probability of sarcopenia and the following functional outcome measures: (1) total Barthel index (BI) score; and (2) BI walking mobility subitem. Each analysis adjusted for the following covariates: age, gender, admission diagnoses, body mass index, comorbidity, C-reactive protein, number of medications on admission, Mini- Mental State Examination total score, and change in the functional outcome measure from admission to discharge. Results: Patients were mainly female (66%) with a mean age of 82 ± 7 years. The mean probability of sarcopenia overall was 60%. About one-half of the patients had a probability of sarcopenia ≥75% (N = 140). The remaining patients were distributed as follows: probability of sarcopenia <25% (N = 79); 25%-49% (N = 26); and 50%-74% (N = 34). The probability of sarcopenia was significantly associated with an overall worse functional status at discharge based on total BI score (point estimate -8.5; standard error 17.1; P < .0001) and ability to walk at discharge as measured with the BI walking mobility subitem (point estimate -1.3; standard error 0.5; P = .02) after adjusting for relevant covariates. Conclusions: These findings support the use of a simple screening tool for probable sarcopenia among older adults receiving in-hospital rehabilitation to increase the ability of clinicians to initiate early interventions to improve functional outcomes at discharge.
Morandi, A., Onder, G., Fodri, L., Sanniti, A., Schnelle, J., Simmons, S., et al. (2015). The Association Between the Probability of Sarcopenia and Functional Outcomes in Older Patients Undergoing In-Hospital Rehabilitation. JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, 16(11), 951-956 [10.1016/j.jamda.2015.05.010].
The Association Between the Probability of Sarcopenia and Functional Outcomes in Older Patients Undergoing In-Hospital Rehabilitation
BELLELLI, GIUSEPPEUltimo
2015
Abstract
Objective: Sarcopenia is a geriatric syndrome with a prevalence ranging from 5% to 50% in community-dwelling adults. It is associated with adverse outcomes including worse functional status, falls, and mortality. A paucity of studies have included an assessment of sarcopenia among older adults receiving in-hospital rehabilitation. This is, at least partially, due to the lack of simple assessment methods to reliably measure muscle mass. The objective of this study was to evaluate the probability of sarcopenia using a validated simple method and examine the association between sarcopenia and functional outcomes at discharge. Setting: One in-hospital rehabilitation setting. Design: Prospective cohort study. Participants: A total of 280 patients 65 years and older who were admitted to in-hospital rehabilitation. Measurements: The probability of sarcopenia was determined using a validated method that includes 3 variables: age, grip strength, and calf circumference. Two multivariable linear regression models were used to analyze the association between the probability of sarcopenia and the following functional outcome measures: (1) total Barthel index (BI) score; and (2) BI walking mobility subitem. Each analysis adjusted for the following covariates: age, gender, admission diagnoses, body mass index, comorbidity, C-reactive protein, number of medications on admission, Mini- Mental State Examination total score, and change in the functional outcome measure from admission to discharge. Results: Patients were mainly female (66%) with a mean age of 82 ± 7 years. The mean probability of sarcopenia overall was 60%. About one-half of the patients had a probability of sarcopenia ≥75% (N = 140). The remaining patients were distributed as follows: probability of sarcopenia <25% (N = 79); 25%-49% (N = 26); and 50%-74% (N = 34). The probability of sarcopenia was significantly associated with an overall worse functional status at discharge based on total BI score (point estimate -8.5; standard error 17.1; P < .0001) and ability to walk at discharge as measured with the BI walking mobility subitem (point estimate -1.3; standard error 0.5; P = .02) after adjusting for relevant covariates. Conclusions: These findings support the use of a simple screening tool for probable sarcopenia among older adults receiving in-hospital rehabilitation to increase the ability of clinicians to initiate early interventions to improve functional outcomes at discharge.
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