Acute sarcopenia changes following hospitalization: influence of pre-admission care dependency level

Abstract

Introduction Hospitalization is associated with acute changes in sarcopenia status in older people, but the influencing factors are not fully understood. Pre-admission care dependency level as a risk factor has not yet been investigated. Objective Evaluate if pre-admission care dependency level is an independent predictor of sarcopenia changes following hospitalization. Setting and subjects Data came from the Sarcopenia 9+ EAMA Project, a European prospective multi-centre study. For this study, 227 hospitalised older people were included from four different hospitals in Belgium, Spain and Poland, between 18 February 2019 and 5 September 2020. Methods Sarcopenia status at admission and discharge were calculated using a combined score (desirability value) based on muscle mass (calf circumference), strength (grip) and function (walking speed). Ratio of admission to discharge status was the outcome (desirability ratio; 1.00 meaning no difference). Predictor variable was the pre-admission care dependency level, classified into three groups: independent older people living at home, dependent older people living at home and older people living in a care home. Linear regression models were applied, considering potential confounders. Results Mean desirability ratio for dependent older people living at home (‘middle dependent group’) was lower (0.89) compared to independent older people (0.98; regression coefficient −0.09 [95% CI −0.16, −0.02]) and care home patients (1.05; −0.16 [95% CI −0.01, −0.31]). Adjusting for potential confounders or using another statistical approach did not affect the main results. Conclusion Dependent older people living at home were at higher risk of deterioration in sarcopenia status following hospitalization. In-depth studies investigating causes and potential interventions of these findings are needed.

COVID-19 in Older Patients: Assessment of Post-COVID-19 Sarcopenia

“…Ageing produces changes in body composition [ 32 ], and sarcopenia increases with age [ 33 ], which could be another reason for the high rate of sarcopenia in our study, as previously demonstrated by other authors [ 34 ]. However, the degree of sarcopenia may be influenced by various risk factors, such as age, a prolonged hospital stay > 7 days, the need for invasive mechanical ventilation, and obesity [ 24 ].…”

Prevalence of Sarcopenia in Patients With COVID-19: A Systematic Review and Meta-Analysis

“…The relationship between sarcopenia and COVID-19 has received substantial interest in the current literature. Hospitalization has been confirmed to be associated with acute changes in sarcopenia status in older people ( 20 , 21 ). Studies of hospitalized patients have described biochemical evidence of muscle damage ( 22 ) during the pandemic, and it has been speculated that patients with COVID-19 are at increased risk of acute sarcopenia ( 23 , 24 ), which is characterized by low skeletal muscle mass (LSMM) and reduced strength.…”

Age-specific rates of hospital transfers in long-stay nursing home residents

“…Hospital transfers are stressful for nursing home residents and their families, increase care costs, and lead to unintended consequences such as nosocomial infections, as well as cognitive and functional decline [1][2][3][4] . Compared to older adults living in the community, nursing home residents experience more hospital transfers.…”