Abstract
Objective
The aim of this study was to evaluate the effect of sarcopenic obesity on activities
of daily living and home discharge rates in adults undergoing convalescent rehabilitation.
In addition, we evaluated diagnostic criteria for sarcopenic obesity to predict outcomes.
Design
A retrospective cohort study.
Setting and Participants
In total, 971 Japanese patients in a post-acute rehabilitation hospital between 2014
and 2016.
Methods
Sarcopenic obesity was defined as the presence of both sarcopenia and obesity. Sarcopenia
was diagnosed using muscle mass index and handgrip strength according to the criteria
of the European Working Group on Sarcopenia in Older People, with the cut-off values
of the Asian Working Group for Sarcopenia. Obesity was diagnosed exploratively using
several definitions: percentage of body fat (FAT%), body mass index (>25 kg/m2), and fat mass index (4th quartile). Study outcomes included Functional Independence
Measure-motor efficacy (score gain between admission and discharge divided by the
length of stay) and the rate of home discharge. Multivariate analyses were used to
determine whether sarcopenic obesity was associated with outcomes and which obesity
definition was suitable for outcome prediction. P values of <.05 were considered statistically significant.
Results
After enrollment, 917 patients (mean age 74.7 ± 13.5 years; 59% women) were included
in the final analyses. The frequency of sarcopenic obesity varied greatly depending
on the sex and method of obesity diagnosis: 2.1% when body mass index >25 kg/m2 was used for obesity diagnosis in men, and 40.7% when FAT% >25% was used in women.
Further, FAT% >35% and FAT% >30% used in women and men, respectively, had the strongest
association with Functional Independence Measure-motor efficacy. FAT% of >30% and
>35% in women and >30 in men was associated with the rate of home discharge.
Conclusions and Implications
Sarcopenic obesity was negatively associated with functional improvement and home
discharge in post-acute rehabilitation. Clinical thresholds for diagnosing sarcopenic
obesity should include FAT% >35 and >30% in women and men, respectively, in defining
obesity in this population.
Keywords
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Article info
Publication history
Published online: May 20, 2020
Footnotes
This research did not receive any funding from agencies in the public, commercial, or not-for-profit sectors.
Identification
Copyright
© 2020 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
