Original articleSarcopenia: Prevalence and prognostic significance in hospitalized patients
Introduction
An important challenge of modern medicine is to distinguish physiological changes associated with the process of ageing from disease and adverse life style factors whose cumulative effects account for many of the adverse events in older people. Although a number of these changes and events lead to progressive decline in health many are responsive to treatment. This has created a need for additional knowledge of age-related changes, which has importance in the treatment and prevention of disease, and in maintaining good health and quality of life in an ageing population. An important example of this challenge is sarcopenia, a condition which is prevalent in older populations with many causes and varying outcomes.1 It is a syndrome characterized by progressive decline in skeletal mass, decreased strength and functional status and associated with physical disability, poor quality of life and death.2, 3 There are a number of mechanisms involved in the aetiology and pathogenesis of sarcopenia and their contribution vary over time. Recognizing underlying causes is expected to help guide treatment and therefore minimize adverse outcomes.4, 5, 6 Currently the presence of low muscle mass and low muscle function (strength or performance) are used for the diagnosis of sarcopenia.2, 5, 6 Although sarcopenia has emerged as an acceptable syndrome which predict outcomes not many data on hospitalized patients are available. Furthermore a valid and reproducible measurement technique of sarcopenia suitable for clinical practice is still a challenge. The aim of this report is to measure the prevalence and prognostic significance of sarcopenia in a cohort of acutely ill older patients.
Section snippets
Subjects
Four hundred and thirty two unselected acutely ill older patients who took part in a randomized controlled trial with complete data were included.7 Inclusion criteria were: age ≥ 65 years; stable medical condition and able to sign an informed written consent form. Patients excluded from the study were those with severe medical or psychiatric illness including those with malignancy, severe dementia and living in institution. The study received local research ethics committee approval.
All
Results
All 432 acutely ill older patients who took part in a previously published randomized controlled trial with complete data were included in this analysis.7 Forty- four out of 432 patients (10%) were diagnosed with sarcopenia. Table 1 shows baseline clinical characteristics according to the presence of the diagnosis of sarcopenia including gender, smoking, alcohol consumption, disability, depression and quality of life scores, tissue inflammation (CRP), haemoglobin, albumin and transferrin.
Discussion
This study shows that older patients with the diagnosis of sarcopenia had poor clinical outcome over 6-month period following acute illness compared with those without sarcopenia after adjusting for a number of important poor prognostic indicators.
Sarcopenia leads to impaired ability to perform activities of daily living, disabilities, loss of independence, increased risk of falls, fractures and death. Despite recent scientific interest in the subject, information on sarcopenia among acutely
Author's contribution
SG is the principal investigator and wrote the first draft of the manuscript. AE contributed to analysis of the data and the discussion. Both authors read and approved the final manuscript.
Conflict of interest
None.
Acknowledgement
The index study was funded by THE HEALTH FOUNDATION project grant. Thank you to Sarah Forster for her help with data collection.
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