Sarcopenia Is Highly Prevalent in Older Medical Patients With Mobility Limitation

Maeda, Keisuke; Shamoto, Hiroshi; Wakabayashi, Hidetaka; Akagi, Junji

doi:10.1177/0884533616680355

Cited by 28 publications

(22 citation statements)

References 33 publications

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“…CC measures not only muscle mass but also bone, subcutaneous adipose, and skin. It is not surprising that the cut-off values in this study were lower because compared with healthy adults, hospitalized patients tend to have an increased malnutrition risk [10,17,18,19] and elderly patients are likely to have thin subcutaneous adipose layers and skin. Therefore, we propose that the CC cut-off values determined in this study would be most useful clinically in hospitalized elderly patients.…”

Section: Discussionmentioning

confidence: 84%

“…SMM was measured using BIA in the supine position using a multi-frequency segmental BIA instrument [9] (Inbody S10, Inbody, Tokyo, Japan), which is the latest version of a validated instrument that uses 6 different frequencies [10]. Skeletal muscle mass index (SMI) was calculated as the measured appendicular muscle mass divided by height squared (kg/m 2 ).…”

Section: Methodsmentioning

confidence: 99%

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Predictive Accuracy of Calf Circumference Measurements to Detect Decreased Skeletal Muscle Mass and European Society for Clinical Nutrition and Metabolism-Defined Malnutrition in Hospitalized Older Patients

Maeda¹,

Koga²,

Nasu³

et al. 2017

Ann Nutr Metab

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Background/Aims: The ability to readily diagnose sarcopenia and malnutrition in a clinical setting is essential. This study is aimed at clarifying the calf circumference (CC) cut-off values for decreased skeletal muscle mass (SMM), according to the Asian Work Group for Sarcopenia's criteria definition of sarcopenia, and those for European Society for Clinical Nutrition and Metabolism-defined malnutrition, in hospitalized Japanese patients. Methods: The study involved 1,164 patients aged ≥65 years. Predictive CC cut-off values were determined using receiver operating curve (ROC) analyses. The predictive validity of the cut-off values was confirmed against in-hospital mortality. Results: There were 654 females and 510 males (mean age, 83.5 ± 8.2 years). Decreased SMM and malnutrition were observed in 80.4 and 32.8% of all patients, respectively. ROC analyses identified CCs of ≤29 cm (female, area under the curve [AUC] 0.791) and ≤30 cm (male, AUC 0.832) as cut-off values for decreased SMM, and CCs of ≤26 cm (female, AUC 0.798) and ≤28 cm (male, AUC 0.837) for malnutrition. CC cut-off values for SMM and malnutrition were independently correlated with in-hospital mortality. Conclusions: The study determined appropriate cut-off values for CC to identify decreased SMM and malnutrition according to the relevant guidelines.

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Section: Discussionmentioning

confidence: 84%

Section: Methodsmentioning

confidence: 99%

Predictive Accuracy of Calf Circumference Measurements to Detect Decreased Skeletal Muscle Mass and European Society for Clinical Nutrition and Metabolism-Defined Malnutrition in Hospitalized Older Patients

Maeda¹,

Koga²,

Nasu³

et al. 2017

Ann Nutr Metab

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“…However, Rodríguez-Rejón et al (34) and Salvà et al (25) also used EWGSOP methodology and identical diagnostic methods and cutoffs in their studies of Spanish old people's homes but, despite applying the same age inclusion criterion (age >70 y), reported very different prevalence values (68% and 37%, respectively). One influential factor may be that individuals with cognitive impairment or inability to walk, known risk factors for sarcopenia (43,44), were included by Rodríguez-Rejón et al (34) but excluded by Salvà et al (25).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Diagnosis of Sarcopenia in Residential Facilities: A Systematic Review

Rodríguez-Rejón

Ruiz-López

Wanden-Berghe

et al. 2019

Advances in Nutrition

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Assessing sarcopenia, the age-related loss of muscle mass and function, in institutionalized older adults is a challenging task. Data on its prevalence in residential facilities are scant and highly variable. Our objective was to report the prevalence of sarcopenia in older adults living in residential facilities (nursing/long term-care homes and assisted-living facilities) and review the criteria and methodologies used to diagnose sarcopenia in this setting. Bibliographic searches were carried out in 6 electronic databases (Medline via PubMed, Web of Science, Scopus, CINAHL, LILACS, and Cochrane) with the use of the Medical Subject Heading terms "Sarcopenia" and "Residential Facilities." We included studies that evaluated the prevalence of sarcopenia among older adults (aged ≥60 y) living in residential facilities. Forty-four studies were identified, of which 21 studies were included after applying eligibility criteria. The reported prevalence of sarcopenia ranged widely between 17.7% and 73.3% in long term-care homes and between 22% and 87% in assisted-living facilities. Most studies (n = 14) followed the consensus on sarcopenia diagnosis published by the European Working Group on Sarcopenia in Older People. In the other 7 studies, sarcopenia was diagnosed according to muscle mass, which was measured via 5 different techniques, most frequently bioelectrical impedance analysis, establishing cutoff scores for low muscle mass with the use of 5 different indexes, most frequently the skeletal muscle index. There are major differences in study design, methodology, and the approach to sarcopenia diagnosis in this setting, which would, in part, explain the enormous variability in the reported prevalence data. The lack of consensus on the correct diagnostic approach hampers the implementation of appropriate nutritional interventions.

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“…Our study showed that the poorest oral health at admission were related to old age, malnutrition, decreased ADL, and impaired cognition. All of these variables are considered to be related to sarcopenia [17,21,22], which is independently associated with poor outcomes, such as mortality, in older adults [23]. Interventions against sarcopenia such as nutritional therapy and rehabilitative exercise along with appropriate oral care intervention may reduce mortality in patients with poor oral health.…”

Section: Discussionmentioning

confidence: 99%

Poor oral health and mortality in geriatric patients admitted to an acute hospital: an observational study

Maeda

2020

BMC Geriatr

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Background: Poor oral health at hospital admission is a potential higher mortality risk predictor. We aimed to determine in-hospital mortality by assessing poor oral health using a validated tool. Methods: A retrospective observational study was conducted in an acute care hospital, and 624 consecutive geriatric patients were included. Patients were divided into three groups according to oral health, stratified by the Oral Health Assessment Tool (OHAT) scores. Nutritional status, daily living activities, cognitive impairment, and comorbidities were collected as covariates. Univariate and multivariate analyses were performed to identify the relationship between oral health and survival. Results: The mean age was 83.8 ± 7.9 years, and 41% were males. Groups with an OHAT score equivalent to 0, 1-2, and ≥ 3 comprised 213, 206, and 205 patients, and 11 (5.2%), 13 (6.3%), and 37 (18.0%) of those patients died in the hospital, respectively. Patients in the OHAT score ≥ 3 group had higher mortality than those in the other groups (log-rank test: p = 0.012 for the OHAT = 0 group; p = 0.010 for the OHAT = 1-2 group after Bonferroni corrections). Patients in the OHAT score ≥ 3 group continued to have poor survival even after adjusting for confounders in the Cox's regression analysis (hazard ratio: 2.514, 95% confidence interval: 1.220-5.183, p = 0.012). Conclusion: In geriatric patients, poor oral health at hospital admission was an independent in-hospital mortality predictor. Future studies on oral care intervention stratified by oral health conditions are warranted.

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Sarcopenia Is Highly Prevalent in Older Medical Patients With Mobility Limitation

Abstract: Patients with dependent ambulatory status experienced a higher prevalence of sarcopenia compared with those with ambulation; in addition, decline in ambulatory status was an independent indicator for the presence of sarcopenia after adjustment for potential confounders.

Cited by 28 publications

References 33 publications

Predictive Accuracy of Calf Circumference Measurements to Detect Decreased Skeletal Muscle Mass and European Society for Clinical Nutrition and Metabolism-Defined Malnutrition in Hospitalized Older Patients

Predictive Accuracy of Calf Circumference Measurements to Detect Decreased Skeletal Muscle Mass and European Society for Clinical Nutrition and Metabolism-Defined Malnutrition in Hospitalized Older Patients

Prevalence and Diagnosis of Sarcopenia in Residential Facilities: A Systematic Review

Poor oral health and mortality in geriatric patients admitted to an acute hospital: an observational study

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