Change in muscle strength and muscle mass in older hospitalized patients: A systematic review and meta-analysis

Ancum, Jeanine M. Van; Scheerman, Kira; Jonkman, Nini H.; Smeenk, Hanne E.; Kruizinga, Roeliene C.; Meskers, Carel G.M.; Maier, Andrea B.

doi:10.1016/j.exger.2017.03.006

Cited by 95 publications

(87 citation statements)

References 60 publications

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“…Sarcopenia is present in 10-25% of older hospitalized patients [5,7], but relies on the applied definition [8]. A significant decrease in muscle strength and muscle mass was found during hospitalization of electively admitted older patients [9].…”

Section: Introductionmentioning

confidence: 99%

Lower Cognitive Function in Older Patients with Lower Muscle Strength and Muscle Mass

Dam

Ancum

Verlaan

et al. 2018

Dement Geriatr Cogn Disord

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Background: Low muscle strength and muscle mass are associated with adverse outcomes in older hospitalized patients. The aim of this study was to assess the association between cognitive functioning and muscle strength and muscle mass in hospitalized older patients. Methods: This prospective inception cohort included 378 patients aged 70 years or older. At admission patients were assessed for cognitive functioning by use of the Six-Item Cognitive Impairment Test (6-CIT). Muscle strength and muscle mass were assessed using handheld dynamometry and segmental multifrequency bioelectrical impedance analysis, within 48 h after admission and on day 7, or earlier on the day of discharge. Results: The data of 371 patients (mean age ± standard deviation 80.1 ± 6.4 years, 49.3% female) were available for analyses. The median (interquartile range) 6-CIT score was 4 (0-8) points. At admission, lower cognitive functioning was associated with lower muscle strength, lower skeletal muscle mass (SMM), lower appendicular lean mass, and lower SMM index. Cognitive functioning was not associated with change in muscle strength and muscle mass during hospitalization. Conclusion: This study further strengthens evidence for an association between lower cognitive functioning and lower muscle strength and muscle mass, but without a further decline during hospitalization.

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Section: Introductionmentioning

confidence: 99%

Lower Cognitive Function in Older Patients with Lower Muscle Strength and Muscle Mass

Dam

Ancum

Verlaan

et al. 2018

Dement Geriatr Cogn Disord

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“…In support of this hypothesis, a previous study showed that community-dwelling older people, who had been hospitalized during the previous year, had significant lower muscle strength and muscle mass compared to people who had not been admitted [10] . We recently performed a meta-analysis on the change of muscle strength and muscle mass in older patients during hospitalization and found evidence for a decrease in muscle strength and muscle mass in electively admitted patients, whereas no significant change was found in acutely admitted patients [11] . However, the included studies were small and did not identify individual risk factors for a decrease in muscle strength and muscle mass.…”

Section: Introductionmentioning

confidence: 99%

Muscle Strength and Muscle Mass in Older Patients during Hospitalization: The EMPOWER Study

et al. 2017

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Background: Low muscle strength and muscle mass are associated with an increased length of hospital stay and higher mortality rate in inpatients. To what extent hospitalization affects muscle strength and muscle mass is unclear. Objective: We aimed to assess muscle strength and muscle mass at admission and during hospitalization in older patients and its relation with being at risk of geriatric conditions. Methods: The EMPOWER study included patients aged 70 years and older, admitted to 4 wards of the VU University Medical Center in the Netherlands between April and December 2015. At admission, patients were screened for being at risk of 4 geriatric conditions: delirium, falls, malnutrition, and functional disability. At admission and at discharge, muscle strength and muscle mass were assessed. Results: A total of373 patients (mean age, standard deviation [SD]: 79.6, 6.38 years) were included at admission, and 224 patients (mean age, SD: 80.1, 6.32 years) at discharge. At admission, lower muscle strength in both female and male patients and low muscle mass in male patients were associated with being at risk of a higher cumulative number of geriatric conditions. Muscle strength increased during hospitalization, but no change in muscle mass was observed. Changes in muscle measures were not associated with being at risk of geriatric conditions. Discussion: Older patients with lower muscle strength and muscle mass at admission were at risk of a higher cumulative number of geriatric conditions. However, being at risk of geriatric conditions did not forecast further decrease in muscle strength and muscle mass during hospitalization

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“…Based on the research mentioned previously, it at least seems reasonable that some patients do; however, studies that have directly investigated in‐hospital changes in muscle mass are extremely sparse. In fact, the small body of evidence actually suggests that there is no significant loss of whole‐body muscle mass during short‐term hospitalization . Contrary, a significant loss of muscle mass was found in an observational cohort study of elderly who were hospitalized for more than eight non‐consecutive days within a year .…”

Section: Changes In Muscle Massmentioning

confidence: 93%

“…However, only a handful of studies have directly measured whether such a loss actually occurs during acute hospitalization. A recent meta‐analysis investigated changes in muscle mass in older patients during either elective or acute admission . The electively admitted patients showed a decrease in muscle mass [standardized mean difference (95% confidence interval): −0.44 (−0.61, −0.27)], whereas the acutely admitted showed no change [−0.25 (−0.58, 0.09)].…”

Section: Introductionmentioning

confidence: 99%

Changes in muscle mass during acute short-term hospitalization of elderly patients: A mini-review

Norheim

2018

Transl Sports Med

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It has long been a presumption that hospitalization is associated with a loss of muscle mass in elderly patients. However, only a handful of studies have directly measured whether such a loss actually occurs. This mini-review highlights some of the most recent research related to changes in muscle mass during acute shortterm hospitalization of elderly patients. Despite a high prevalence of physical inactivity during hospitalization, there is a lack of research measuring changes for habitual levels. The effect of inflammation on muscle mass in elderly patients is still uncertain. Nutritional supplementation beyond what is currently being prescribed in hospitals may have additional benefits on muscle mass. Dehydration prior to hospital admission may obscure true changes in muscle mass when using current state-of-the-art measures due to in-hospital rehydration. The current literature does not support the notion of in-hospital loss of muscle mass in acutely admitted elderly patients; however, there is a need for more precise measures of muscle mass that are able to account for fluctuations in hydration status. Moreover, future studies assessing changes in muscle mass should also measure changes in physical activity levels, inflammation status, and nutritional intake during acute hospitalization. K E Y W O R D Satrophy, disuse, elderly, hydration status, inflammation, protein intake | INTRODUCTIONThere are several physiological changes related to increasing age in humans, one of which is the progressive loss of skeletal muscle mass. 1 This loss, which has been termed sarcopenia, is multifactorial in nature and its exact etiology is yet to be established. A large body of research has been put into understanding this phenomenon, mostly focusing on factors such as physical inactivity, poor nutrition, inflammatory processes, and endocrine changes. Interestingly, some researchers have suggested that repeated hospitalizations in elderly may accelerate sarcopenia. 2 It has long been a presumption that hospitalization is associated with a loss of muscle mass in elderly patients. However, only a handful of studies have directly measured whether such a loss actually occurs during acute hospitalization. A recent meta-analysis investigated changes in muscle mass in older patients during either elective or acute admission. 3 The electively admitted patients showed a decrease in muscle mass [standardized mean difference (95% confidence interval): À0.44 (À0.61, À0.27)], whereas the acutely admitted showed no change [À0.25 (À0.58, 0.09)]. Although only two studies were used in the analysis of acutely admitted patients, other studies that were not included show similar results. 4,5 Several factors may explain these findings. This mini-review highlights some of the most recent studies in the field of geriatrics with a focus on changes in muscle mass during acute short-term hospitalization of elderly patients. The main putative mechanisms explaining these findings are discussed, and a hypothetical model illustrating changes in muscle m...

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Change in muscle strength and muscle mass in older hospitalized patients: A systematic review and meta-analysis

Cited by 95 publications

References 60 publications

Lower Cognitive Function in Older Patients with Lower Muscle Strength and Muscle Mass

Lower Cognitive Function in Older Patients with Lower Muscle Strength and Muscle Mass

Muscle Strength and Muscle Mass in Older Patients during Hospitalization: The EMPOWER Study

Changes in muscle mass during acute short-term hospitalization of elderly patients: A mini-review

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