Abstract
Objective
Sarcopenia is highly prevalent in hospitalized older patients and associated with
short-term mortality. This study aimed to investigate whether sarcopenia and its measures
handgrip strength (HGS) and muscle mass at hospital admission were associated with
long-term mortality in a cohort of hospitalized older patients.
Design
Observational, prospective, longitudinal inception cohort study.
Setting and Participants
Academic teaching hospital; patients age ≥70 years admitted to the internal medicine,
acute admission, trauma, or orthopedic wards.
Methods
HGS and muscle mass were measured at admission using a hand dynamometer and bioelectrical
impedance analysis. Sarcopenia was determined based on the European Working Group
on Sarcopenia in Older People definition. HGS and muscle mass (skeletal muscle mass
index, appendicular lean mass, relative skeletal muscle mass) were expressed as sex-specific
tertiles. The associations of sarcopenia, HGS, and muscle mass with mortality (during
a follow-up of 3.4-4.1 years) were analyzed using Cox regression, adjusted for age,
sex, comorbidity, and weight or height. Associations of HGS and muscle mass were stratified
by sex.
Results
Out of 363 patients [mean age: 79.6 years (standard deviation: 6.4), 49.9% female]
49% died. Probable sarcopenia (prevalence of 53.7%) and sarcopenia (prevalence of
20.8%) were significantly associated with long-term mortality [hazard ratio (HR) 1.53,
95% confidence interval (CI) 1.08‒2.17 and 1.71 95% CI 1.12‒2.61, respectively]. Low
HGS, skeletal muscle mass index, and appendicular lean mass were associated with a
higher mortality risk (lowest tertile vs highest tertile: HR 2.660, 95% CI 1.40‒5.05;
HR 1.95, 95% CI 1.06‒3.58 and HR 1.99 (95% CI 1.12‒3.53) in male patients. No statistically
significant associations of relative muscle mass with mortality were found.
Conclusions and Implications
Sarcopenia and its measures (low HGS and low absolute muscle mass at admission) predict
long-term mortality in older hospitalized patients.
Keywords
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Article info
Publication history
Published online: January 13, 2021
Footnotes
This work was supported by European Union’s Horizon 2020 research and innovation program under the Marie Skłodowska-Curie Grant Agreement No. 675003.
The authors declare no conflicts of interest.
Identification
Copyright
© 2021 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
