Muscle Strength and Muscle Mass in Older Patients during Hospitalization: The EMPOWER Study

Ancum, Jeanine M. Van; Scheerman, Kira; Pierik, Vincent D.; Numans, Siger T.; Verlaan, Sjors; Smeenk, Hanne E.; Slee-Valentijn, Monique S.; Kruizinga, Roeliene C.; Meskers, Carel G.M.; Maier, Andrea B.

doi:10.1159/000478777

Cited by 33 publications

(27 citation statements)

References 30 publications

(43 reference statements)

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“…Accumulation of geriatric deconditioning would reflect progression of sarcopenia. A prospective study including older adult inpatients reported that the cumulative number of unfavorable geriatric conditions, such as risk of fall, delirium, malnutrition, and dependency, was negatively correlated to the amount of muscle mass and degree of muscle strength [25]. The results of our current study might signify a similar conclusion that patients with deconditioning accumulation had greater sarcopenia progression than those without accumulation, even in patients with sarcopenia.…”

Section: Discussionsupporting

confidence: 79%

“…A systematic review reported that acute admission, but not elective admission, did not decrease muscle mass and strength [14]. Additionally, Van Ancum et al reported that, in a study involving approximately 85% acute admission cases, muscle strength increased during hospitalization [25]. An acute condition may result in the underestimation of muscle strength due to acute symptoms such as fatigue, decreased temperature, pain, and so on.…”

Section: Discussionmentioning

confidence: 99%

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Development and Predictors of Sarcopenic Dysphagia during Hospitalization of Older Adults

et al. 2019

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The study aimed to investigate the impact of sarcopenia and sarcopenia-related conditions on the development of swallowing disorders during hospitalization. Older adult inpatients (n = 8768) without swallowing disorders in the premorbid period were studied. Sarcopenia-related conditions were evaluated in terms of nutritional status, physical status, and ambulatory conditions as well as hand-grip strength and muscle mass assessed by calf circumference. Development of swallowing disorders was defined based on food texture at discharge from the hospital. The patients’ mean age was 76.1 ± 6.9 years. A total of 374 (4.3%) patients developed swallowing disorders during hospitalization. They were older, with poorer nutritional status, and had more decline of physical performance than those without swallowing disorders. Performance Status score (odds ratio (OR) = 1.28 (1.12–1.46) p < 0.001), ambulatory dependency (OR = 1.72 (1.09–2.71), p = 0.020), malnutrition score (OR = 0.92 (0.87–0.97), p = 0.002), insufficient nutritional intake (OR = 2.33 (1.60–3.40), p < 0.001), and length of stay (OR = 1.01 (1.00–1.01), p = 0.001) were independent contributing factors for swallowing disorder development in the multivariate analysis. The presence of possible sarcopenia was also a contributor to swallowing disorder development. In conclusion, swallowing disorders could develop in patients with possible sarcopenia and sarcopenia-related conditions during hospitalization. Clinicians should be aware of this risk and provide appropriate interventions to prevent sarcopenic dysphagia.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Development and Predictors of Sarcopenic Dysphagia during Hospitalization of Older Adults

et al. 2019

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“…The question whether hospitalization by itself is a risk factor for ALD decline is difficult to answer without comparison to trajectories of ADL decline in similar but not hospitalized subjects. In a previous study, muscle measures were not found to change during hospitalization ( 47 ) although immobilization during hospital stay was found to have acute negative impact on muscle mass and strength ( 48 ), which might be further substantiated after discharge.…”

Section: Discussionmentioning

confidence: 83%

Association of Handgrip Strength and Muscle Mass with Dependency in (Instrumental) Activities of Daily Living in Hospitalized Older Adults -The EMPOWER Study

Meskers

Reijnierse

Numans

et al. 2019

The Journal of nutrition, health and aging

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Objectives Handgrip strength (HGS) and muscle mass are strong predictors for dependency in Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) in community dwelling older adults. Whether this also applies to older hospitalized patients is yet unknown. We studied the association between HGS and muscle mass with ADL and IADL dependency at admission and change of ADL and IADL dependency at three months after discharge in older hospitalized patients. Design Observational longitudinal inception cohort (EMPOWER) including 378 patients aged 70 years and older. Setting Four different clinical wards of a university teaching hospital, The Netherlands. Measurements HGS and muscle mass were measured within 48 hours after admission using hand dynamometry and Bio-electrical Impedance Analysis respectively. ADL dependency was assessed using the Katz score (0-6 points) and IADL dependency using the Lawton and Brody score (0-8 points) within 48 hours after admission and three months after discharge. Results At admission, lower HGS was associated with ADL dependency in both males and females. Lower muscle mass was associated with ADL dependency in males. Lower HGS was associated with IADL dependency, but only in males. Lower HGS at admission in males was associated with an increase in ADL dependency three months after discharge. Conclusion In hospitalized older patients, HGS is associated with ADL and IADL and muscle mass measures with ADL in male patients only. HGS should be explored as predictive marker for outcome of hospitalized older patients after discharge.

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“…The Evaluation of Muscle parameters in a Prospective cohort of Older patients at clinical Wards Exploring Relations with bed rest and malnutrition (EMPOWER) study was a prospective, inception cohort study conducted from April until December 2015 at the VU university medical center in Amsterdam, the Netherlands. An extended description of the protocol is published elsewhere [ 22 ]. In short, patients aged 70 years and older, either electively or acutely admitted to the internal medicine, acute admission, trauma or orthopaedic ward, and who were hospitalized for > 24 h were included in the study.…”

Section: Methodsmentioning

confidence: 99%

Muscle mass and muscle strength are associated with pre- and post-hospitalization falls in older male inpatients: a longitudinal cohort study

et al. 2018

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BackgroundLow muscle mass and strength are highly prevalent in inpatients. It is acknowledged that low muscle mass and strength are associated with falls in community-dwelling older adults, but it is unknown if these muscle measures are also associated with falls in a population of older inpatients. This study aimed to investigate the association between muscle measures and pre- and post-hospitalization falls in older inpatients.MethodsAn inception cohort of patients aged 70 years and older, admitted to an academic teaching hospital, was included in this study. Muscle mass and hand grip strength were measured at admission using bioelectrical impedance analysis and handheld dynamometry. Pre-hospitalization falls were dichotomized as having had at least one fall in the six months prior to admission. Post-hospitalization falls were dichotomized as having had at least one fall during the three months after discharge. Associations were analysed with logistic regression analysis.ResultsThe study cohort comprised 378 inpatients (mean age, SD: 79.7, 6.4 years). Fifty per cent of female and 41% of male patients reported at least one fall prior to hospitalization. Post-hospitalization, 18% of female and 23% of male patients reported at least one fall. Lower muscle mass was associated with post-hospitalization falls, and lower hand grip strength was associated with both pre- and post-hospitalization falls in male, but not in female, patients.ConclusionsThese findings confirm the likely involvement of muscle mass and strength in the occurrence of pre- and post-hospitalization falls in a population of older inpatients, but only in males.Electronic supplementary materialThe online version of this article (10.1186/s12877-018-0812-5) contains supplementary material, which is available to authorized users.

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Muscle Strength and Muscle Mass in Older Patients during Hospitalization: The EMPOWER Study

Cited by 33 publications

References 30 publications

Development and Predictors of Sarcopenic Dysphagia during Hospitalization of Older Adults

Development and Predictors of Sarcopenic Dysphagia during Hospitalization of Older Adults

Association of Handgrip Strength and Muscle Mass with Dependency in (Instrumental) Activities of Daily Living in Hospitalized Older Adults -The EMPOWER Study

Muscle mass and muscle strength are associated with pre- and post-hospitalization falls in older male inpatients: a longitudinal cohort study

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