Impact of Sarcopenia and Frailty in a Multicenter Cohort of Polypathological Patients

Abstract

The prevalence, relationships and outcomes of sarcopenia and frailty in polypathological patients remain unknown. We performed a multicenter prospective observational study in six hospitals in order to assess prevalence, clinical features, outcome and associated risk factors of sarcopenia and frailty in a hospital-based population of polypathological patients. The cohort was recruited by performing prevalence surveys every 14 days during the inclusion period (March 2012–June 2016). Sarcopenia was assessed by means of EWGSOP criteria and frailty by means of Fried’s criteria. Skeletal muscle mass was measured by tetrapolar bioimpedanciometry. All patients were followed for 12 months. Factors associated with sarcopenia, frailty and mortality were analyzed by multivariate logistic regression, and Kaplan–Meier curves. A total of 444 patients (77.3 ± 8.4 years, 55% males) were included. Sarcopenia was present in 97 patients (21.8%), this being moderate in 54 (12.2%), and severe in 43 (9.6%); frailty was present in 278 patients (62.6%), and 140 (31.6%) were pre-frail; combined sarcopenia and frailty were present in the same patient in 80 (18%) patients. Factors independently associated to the presence of both, sarcopenia and frailty were female gender, older age, different chronic conditions, poor functional status, low body mass index, asthenia and depressive disorders, and low leucocytes and lymphocytes count. Mortality in the 12-months follow-up period was 40%. Patients with sarcopenia, frailty or both survived significantly less than those without these conditions. Sarcopenia and frailty are frequent and interrelated conditions in polypathological patients, shadowing their survival. Their early recognition and management could improve health-related outcomes in this population.

Prognostic Impact of Low Skeletal Muscle Mass on Major Adverse Cardiovascular Events in Coronary Artery Disease: A Propensity Score-Matched Analysis of a Single Center All-Comer Cohort

“…The negative impacts of frailty on patients with CAD undergoing PCI were consistent with the previous study results [32]. It is well known that both sarcopenia and frailty share overlapping characteristics in a variety of pathophysiologic conditions [33,34,35]. The CFS was able to predict the risk of 3-year all-cause mortality similarly to the CT-determined low L1 SMI.…”

Oxidative Stress, Telomere Shortening, and Apoptosis Associated to Sarcopenia and Frailty in Patients with Multimorbidity

“…Mortality in the 12-months follow-up period was 40% ( N = 178). A detailed clinical description of the included patients has already been published [ 7 ]; briefly, sarcopenia was more frequent in men, and associated to chronic lung diseases, cancer, lower BMI, and previous hospital admissions, whereas frailty was more frequent in women and associated to a higher number of polypathology categories, chronic pain, anxiety, and pressure ulcers; both phenotypes shared association with age, asthenia, and lower BI scores.…”

“…All patients were clinically followed during a 12-month period in order to assess mortality, as previously described [ 7 ]. Time survival was assessed, and in case of death, chronology of the demise was incorporated.…”

“…The development of one or both of them is linked to progressive functional disability, loss of quality of life and death. Their prevalence in elderly populations approximates 10% and 15%, respectively; however, in the presence of chronic conditions and multimorbidity, these prevalences can raise to 20% and 60%, respectively [ 7 ]. Both syndromes are narrowly interrelated; as a matter of fact, they have currently an identical therapeutic approach based on physical activity and optimal nutrition.…”

“…Both syndromes are narrowly interrelated; as a matter of fact, they have currently an identical therapeutic approach based on physical activity and optimal nutrition. In a recent study, both sarcopenia and frailty were present in the same patient in 18% of the studied cases; that is to say that most sarcopenic patients were frail, and about one third of frail patients were sarcopenic [ 7 ]. Nevertheless, these percentages are different in other studies, probably due to sample selection criteria [ 8 ].…”