Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona, Italy; Geriatric Research Group, Brescia, Italy.
Department of Gerontology, Neuroscience and Orthopedics, Catholic University of Sacred Heart, Rome, Italy.
J Am Med Dir Assoc. 2015 Nov 1;16(11):951-6. doi: 10.1016/j.jamda.2015.05.010. Epub 2015 Jun 16.
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.
One in-hospital rehabilitation setting.
Prospective cohort study.
A total of 280 patients 65 years and older who were admitted to in-hospital rehabilitation.
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.
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.
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.
肌少症是一种老年综合征，在社区居住的成年人中的患病率为 5%至 50%。它与不良结局相关，包括更差的功能状态、跌倒和死亡。很少有研究包括对住院康复老年人中肌少症的评估。这至少部分是由于缺乏简单的评估方法来可靠地测量肌肉量。本研究的目的是使用经过验证的简单方法评估肌少症的可能性，并研究肌少症与出院时功能结局之间的关系。
一个住院康复机构。
前瞻性队列研究。
共纳入 280 名 65 岁及以上的住院康复患者。
使用包括 3 个变量的经过验证的方法来确定肌少症的可能性：年龄、握力和小腿围。使用 2 个多变量线性回归模型分析肌少症的可能性与以下功能结局测量指标之间的关系：（1）总巴氏量表（BI）评分；（2）BI 步行移动子项。每个分析均调整了以下协变量：年龄、性别、入院诊断、体重指数、合并症、C 反应蛋白、入院时的药物数量、简易精神状态检查总分以及入院至出院时功能结局的变化。
患者主要为女性（66%），平均年龄为 82 ± 7 岁。总体肌少症的可能性平均为 60%。约有一半的患者肌少症的可能性≥75%（N = 140）。其余患者的分布如下：肌少症的可能性<25%（N = 79）；25%-49%（N = 26）；50%-74%（N = 34）。经过相关协变量调整后，肌少症的可能性与出院时整体功能状态较差（BI 总分的点估计值-8.5；标准误差 17.1；P <.0001）和出院时步行能力（BI 步行移动子项的点估计值-1.3；标准误差 0.5；P =.02）显著相关。
这些发现支持在接受住院康复的老年人中使用简单的筛查工具来确定可能的肌少症，以提高临床医生识别肌少症并尽早干预以改善出院时功能结局的能力。
