Falls among older adults with sarcopenia dwelling in nursing home or community: A meta-analysis

Zhang, Xiaoming; Huang, Pan; Dou, Qingli; Wang, Conghua; Zhang, Wenwu; Yang, Yongxue; Wang, Jiang; Xie, Xiaohua; Zhou, Jianghua; Zeng, Yingchun

doi:10.1016/j.clnu.2019.01.002

Cited by 121 publications

(97 citation statements)

References 46 publications

(43 reference statements)

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“…Furthermore, our study found that the prevalence of sarcopenia in breast cancer patients was 45% [95% CI: 32-57], which was higher than in community-dwelling older adults [32]. Considering this together with the results of previous studies substantiating that sarcopenia can increase the risk of negative clinical outcomes [33,34], it is recommended that assessment of sarcopenia should be incorporated as part of the routine clinical assessment for patients with breast cancer, particularly for those who are in the early stage. In addition, metastatic breast cancer patients usually receive chemotherapy or radiotherapy to increase their overall likelihood of survival.…”

Section: Discussionsupporting

confidence: 74%

Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review

et al. 2020

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Background: Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death in women worldwide. Recently, studies have been published with inconsistent findings regarding whether sarcopenia is a risk factor for mortality in breast cancer patients. Therefore, the aim of this systematic review and meta-analysis was to systematically assess and quantify sarcopenia as a risk factor for mortality in breast cancer patients. Methods: In a systematic literature review of PubMed, EMBASE, and the Cochrane CENTRAL Library, we searched for observational studies written in English (from database inception until April 30, 2019) that reported an association between sarcopenia and breast cancer in women who were 18 years or older. Results: A total of six studies (5497 participants) were included in this meta-analysis. Breast cancer patients with sarcopenia were associated with a significantly higher risk of mortality, compared to breast cancer patients without sarcopenia (pooled HR-hazard ratio = 1.71, 95% CI: 1.25-2.33, I 2 = 59.1%). In addition, the results of age subgroup analysis showed that participants younger than 55 years with sarcopenia had a lower risk of mortality than participants aged 55 years and older with sarcopenia (pooled HR = 1.46, 95% CI: 1.24-1.72 versus pooled HR = 1.99, 95% CI: 1.05-3.78), whereas both have an increased risk of mortality compared to non-sarcopenic patients. Subgroup analyses regarding stage at diagnosis revealed an increased risk of mortality in non-metastatic patients compared to participants without sarcopenia (pooled HR = 1.91, 95% CI: 1.32-2.78), whereas the association was not significant in metastatic breast cancer patients. Other subgroup analyses were performed using different follow-up periods (> 5 years versus ≤5 years) and the results were different (pooled HR = 1.81, 95% CI: 1.23-2.65 versus pooled HR = 1.70, 95% CI: 0.80-3.62). Conclusions: The present study found that sarcopenia is a risk factor for mortality among female early breast cancer patients. It is imperative that more research into specific interventions aimed at treating sarcopenia be conducted in the near future in order to provide evidence which could lead to decreased mortality rates in breast cancer patients.

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Section: Discussionsupporting

confidence: 74%

Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review

et al. 2020

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“…Then, we chose the newest meta‐analysis with the largest number of studies. Finally, 54 health‐related outcomes extracted from 30 meta‐analyses 10,22‐50 were reported in this umbrella review. These 54 outcomes were mainly about prognostic outcomes of tumor, postoperative outcomes, age‐related outcomes, metabolic outcomes, and other outcomes.…”

Section: Resultsmentioning

confidence: 99%

Sarcopenia and adverse health‐related outcomes: An umbrella review of meta‐analyses of observational studies

et al. 2020

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Objective The purpose of this umbrella review was to assess the associations between sarcopenia and adverse health‐related outcomes. Design An umbrella review of meta‐analyses of observational studies. Setting and Participants Patients with sarcopenia and controls without sarcopenia were included. Measures The PubMed, Web of Science and Embase were searched for relevant systematic review and meta‐analysis. AMSTAR and GRADE system were used for methodological quality and evidence quality assessments, respectively. Results Totally 54 outcomes extracted from 30 meta‐analyses were analyzed. Twenty out of 21 prognostic outcomes indicated that sarcopenia was significantly associated with poorer prognosis of gastric cancer, hepatocellular cancer, urothelial cancer, head and neck cancer, hematological malignancy, pancreatic cancer, breast cancer, colorectal cancer, lung cancer, esophageal cancer, and ovarian cancer. Besides, 10 out of 16 postoperative outcomes suggested that sarcopenia significantly increased the risk of multiple postoperative complications and prolonged the length of hospitalization of patients with digestive cancer. In age‐related outcomes, sarcopenia significantly increased the risk of dysphagia, cognitive impairment, fractures, falls, hospitalization, and all‐cause mortality of elderly populations. Moreover, sarcopenia was also associated with higher level of albuminuria, risk of depression, and several metabolic diseases. Conclusions and Implications Sarcopenia significantly affected a wide range of adverse health‐related outcomes, particularly in patients of tumor and elderly populations. Because evidences of most outcomes were rated as “low” and “very low,” more prospective cohort studies are required in the future.

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“…While literature regarding sarcopenia in orthopaedic-specific surgical procedures is sparse, our results are consistent with the literature, which include findings of increased fall risk in patients with sarcopenia. 6 Using data from the "Invecchiamento e Longevità nel Sirente" (Aging and Longevity in the Sirente geographic area, ilSIRENTE) study, Landi et al demonstrated that patients with sarcopenia were thrice more likely to experience falls (hazard ratio [HR] ¼ 3.23; 95% CI: 1.25-8.29). 8 In a 2-year prospective cohort study of 162 participants, Matsumoto et al found sarcopenia to be a predictor of falls in independently living older adults (OR ¼ 7.68; 95% CI: 1.41-41.77, p ¼ 0.018).…”

Section: Discussionmentioning

confidence: 99%

Comparative Analysis on the Effects of Sarcopenia following Primary Total Knee Arthroplasty: A Retrospective Matched-Control Analysis

et al. 2020

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AbstractDespite the high incidence of sarcopenia in the orthopaedic community, studies evaluating the influence of sarcopenia following primary total knee arthroplasty (TKA) are limited. Therefore, the purpose of this study is to determine if sarcopenic patients undergoing primary TKA have higher rates of (1) in-hospital lengths of stay (LOS); (2) medical complications; (3) implant-related complications; (4) fall risk; (5) lower extremity fracture risk; and (6) costs of care. Sarcopenia patients were matched to controls in a 1:5 ratio according to age, sex, and medical comorbidities. The query yielded 90,438 patients with (n = 15,073) and without (n = 75,365) sarcopenia undergoing primary TKA. Primary outcomes analyzed included: in-hospital LOS, 90-day medical complications, 2-year implant-related complications, fall risk, lower extremity fracture risk, and costs of care. A p-value of less than 0.05 was considered statistically significant. Patients with sarcopenia undergoing primary TKA had greater in-hospital LOS (4 vs. 3 days, p < 0.0001). Sarcopenic patients were also found to have increased incidence and odds of 90-day medical complications (2.9 vs. 1.1%; odds ratio [OR] = 2.83, p < 0.0001), falls (0.9 vs. 0.3%; OR = 3.54, p < 0.0001), lower extremity fractures (1.0 vs. 0.2%; OR = 5.54, p < 0.0001), and reoperation (0.9 vs. 0.5%; OR = 1.87, p < 0.0001). Additionally, sarcopenic patients had greater 2-year implant-related complications (4.3 vs. 2.4%; OR = 1.80, p < 0.0001), as well as day of surgery ($52,900 vs. 48,248, p < 0.0001), and 90-day ($68,303 vs. $57,671, p < 0.0001) costs compared with controls. This analysis of over 90,000 patients demonstrates that patients with sarcopenia undergoing primary TKA have greater in-hospital LOS, increased odds of 90-day medical complications, falls, lower extremity fractures, and reoperations. Additionally, sarcopenia was associated with greater 2-year implant-related complications, day of surgery costs, and 90-day costs. The study is useful as it can allow orthopaedic surgeons to properly educate these patients of the potential complications which may occur following their surgery.

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Falls among older adults with sarcopenia dwelling in nursing home or community: A meta-analysis

Cited by 121 publications

References 46 publications

Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review

Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review

Sarcopenia and adverse health‐related outcomes: An umbrella review of meta‐analyses of observational studies

Comparative Analysis on the Effects of Sarcopenia following Primary Total Knee Arthroplasty: A Retrospective Matched-Control Analysis

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