Malnutrition-sarcopenia syndrome and all-cause mortality in hospitalized older people

Gümüşsoy, Mesut; Atmış, Volkan; Yalçın, Ahmet; Bahşi, Remzi; Yiğit, Seher; Ari, Sinan; Dokuyan, Haydar Can; Gözükara, Melih Gaffar; Sılay, Kamile

doi:10.1016/j.clnu.2021.09.036

Cited by 33 publications

(19 citation statements)

References 50 publications

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“…To the best of our knowledge, the prevalence of MSS and this study’s variables have not been examined among CCRC residents. However, limited studies examined the prevalence of MSS among older adults in other settings such as hospitals, rehabilitation facilities, and nursing homes [ 33 , 34 , 35 ]. The prevalence of MSS in our study was higher compared to two recent studies conducted among hospitalized older adults and nursing home residents.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of MSS in our study was higher compared to two recent studies conducted among hospitalized older adults and nursing home residents. Both studies used the EWGSOP2 criteria for sarcopenia (using bioimpedance analysis (BIA) for estimating muscle mass) and MNA criteria for malnutrition and showed MSS prevalence of 4.6% ( n = 350) [ 33 ] and 5% ( n = 92) [ 35 ], respectively. The prevalence in our study was also higher than that in a previous report of an Asian population where the Asia Working Group for Sarcopenia (AWGS) criteria for sarcopenia (using an equation validated in a Chinese population for estimating muscle mass) and MNA criteria for malnutrition were used ( n = 453; MSS = 5.5%) [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

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Malnutrition–Sarcopenia Syndrome and Self-Management Behaviors in Continuing-Care Retirement Community Residents

2021

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Malnutrition–sarcopenia syndrome (MSS) might put older adults at higher risk for disability, frailty, and mortality. This study examined the prevalence and association of the self-management-process factors (i.e., self-efficacy and aging expectations) and behaviors (protein and caloric intake and sedentary and physical-activity behaviors) to MSS among older adults living in continuing care retirement communities (CCRCs). Using a cross-sectional correlational design, data of 96 CCRC residents (82.4 ± 7.4 years) were analyzed. Muscle mass, strength, function, nutritional status, sedentary time, physical activity levels, protein and caloric intake, self-efficacy for physical activity, aging expectations, and physical and mental health-related quality of life were measured. Results show that 36 (37.5%) had sarcopenia, 21 (21.9%) had malnutrition risk, 13 (13.4%) had malnutrition, and 12 (12.5%) had MSS. We also found that high time spent in sedentary behaviors (OR = 1.041; 95% CI: 1.011–1.071) was associated with higher odds of having MSS and high expectations regarding aging (OR = 0.896; 95% CI: 0.806–0.997) was associated with less likelihood of having MSS. Findings suggest that CCRC residents should be screened for MSS. Self-management interventions that consider the self-management-process factors are needed to prevent MSS and mitigate its negative outcomes among CRCC residents.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Malnutrition–Sarcopenia Syndrome and Self-Management Behaviors in Continuing-Care Retirement Community Residents

2021

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“…Sipers et al reported that the 2-year mortality risk in the sarcopenia group was 4.3-fold higher among acutely hospitalized elderly patients, 7 whereas Gümüşsoy et al reported that the mortality risk in patients with both malnutrition and sarcopenia was 19.9 times higher than that in the normal group. 8 There are various methods for measuring muscle mass to diagnose sarcopenia, such as dual-energy X-ray absorptiometry, magnetic resonance imaging, computed tomography, bioelectrical impedance analysis (BIA) and bioimpedance spectroscopy (BIS). However, there are some hurdles to their practical use in the clinical field, such as cost, accessibility and radiation.…”

Section: Introductionmentioning

confidence: 99%

“…Sarcopenia is associated with a higher mortality risk in geriatric patients. Sipers et al reported that the 2‐year mortality risk in the sarcopenia group was 4.3‐fold higher among acutely hospitalized elderly patients, 7 whereas Gümüşsoy et al reported that the mortality risk in patients with both malnutrition and sarcopenia was 19.9 times higher than that in the normal group 8 …”

Section: Introductionmentioning

confidence: 99%

Impact of sarcopenia and phase angle on mortality of the very elderly

Kwon

Lee

Kim

et al. 2022

J cachexia sarcopenia muscle

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Background Sarcopenia is a major component of geriatric syndrome and associated with poor clinical outcomes and mortality. However, diagnosing sarcopenia in the very elderly is difficult, and data on its epidemiology and devastating effects in this group are scarce. Phase angle (PA) is measured using bioimpedance spectroscopy and known to reflect cellular integrity and health. This study aimed to clarify the impact of sarcopenia and PA on mortality risk in very elderly people living in long‐term care facilities. Methods This prospective cohort study enrolled elderly residents living in nine long‐term care facilities. We collected the participants' data, such as body mass index (BMI), comorbidities and laboratory data, from September to October 2017 and mortality data until October 2019. Nutritional status was evaluated using the Mini Nutritional Assessment (MNA) score, and multifrequency bioimpedance spectroscopy was used to assess body composition including PA. Appendicular skeletal muscle mass was calculated using the body composition monitor‐derived equation of Taiwan's researchers. Sarcopenia was diagnosed using the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) definition (sarcopenia vs. normal group). We divided the participants into two groups according to the median PA value of 3.65° (high vs. low group) and performed multivariate regression analyses to verify the association with mortality risk according to sarcopenia diagnosis or PA group. Results A total of 279 elderly participants were enrolled; of them, 238 (85.3%) were diagnosed with sarcopenia according to EWGSOP2 guidelines. The median patient age was 83 years, 211 (75.6%) were female and the median BMI was 20.4 kg/m2. The sarcopenia group was older than the normal group (84 vs. 81 years; P = 0.002), had a lower mean BMI (19.8 vs. 26.6 kg/m2, P < 0.001) and had a lower MNA score (9 vs. 12 points, P < 0.001). Sarcopenia was associated with a higher mortality risk after the adjustment for age, sex and diabetes mellitus (hazard ratio [HR], 3.744; 95% confidence interval [CI], 1.155–12.134; P = 0.028). A low PA was associated with sarcopenia, older age, female sex, low MNA score and overhydration volume; it was also a significant predictor of mortality after the adjustment for age, sex, diabetes mellitus and MNA score (HR, 0.593; 95% CI, 0.420–0.837; P = 0.003). Conclusions Sarcopenia is prevalent among the very elderly patients in long‐term care facilities. Sarcopenia and low PA are significantly associated with higher mortality risk.

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“…A systematic review of seven studies (2506 patients) revealed a high association [OR: 4.06 (95% CI: 2.43, 6.80), I 2 = 71.4%] and considerable overlap (41.6%) between sarcopenia and (risk of) malnutrition in older hospitalized adults [ 19 ]. In addition, when these conditions co-exist, also named malnutrition–sarcopenia syndrome (MSS), they can be a predictor of mortality in older hospitalized patients and a prognostic factor in their management [ 20 , 21 ]. The scarce literature on the prognostic value of this syndrome, not considering elderly patients, and clinical outcomes different from mortality, provides a gap for new studies in the area.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Isolated Sarcopenia or Malnutrition–Sarcopenia Syndrome for Clinical Outcomes in Hospitalized Patients

Sousa

Burgel

Silva³

et al. 2022

Nutrients

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Malnutrition–sarcopenia syndrome (MSS) is frequent in the hospital setting. However, data on the predictive validity of sarcopenia and MSS are scarce. We evaluated the association between sarcopenia and MSS and clinical adverse outcomes (prolonged length of hospital stay—LOS, six-month readmission, and death) using a prospective cohort study involving adult hospitalized patients (n = 550, 55.3 ± 14.9 years, 53.1% males). Sarcopenia was diagnosed according to the EWGSOP2, and malnutrition according to the Subjective Global Assessment (SGA). Around 34% were malnourished, 7% probable sarcopenic, 15% sarcopenic, and 2.5% severe sarcopenic. In-hospital death occurred in 12 patients, and the median LOS was 10.0 days. Within six months from discharge, 7.9% of patients died, and 33.8% were readmitted to the hospital. Probable sarcopenia/sarcopenia had increased 3.95 times (95% CI 1.11–13.91) the risk of in-hospital death and in 3.25 times (95% CI 1.56–6.62) the chance of mortality in six months. MSS had increased the odds of prolonged LOS (OR = 2.73; 95% CI 1.42–5.25), readmission (OR = 7.64; 95% CI 3.06–19.06), and death (OR = 1.15; 95% CI 1.08–1.21) within six months after discharge. Sarcopenia and MSS were predictors of worse clinical outcomes in hospitalized patients.

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Malnutrition-sarcopenia syndrome and all-cause mortality in hospitalized older people

Cited by 33 publications

References 50 publications

Malnutrition–Sarcopenia Syndrome and Self-Management Behaviors in Continuing-Care Retirement Community Residents

Malnutrition–Sarcopenia Syndrome and Self-Management Behaviors in Continuing-Care Retirement Community Residents

Impact of sarcopenia and phase angle on mortality of the very elderly

Prognostic Value of Isolated Sarcopenia or Malnutrition–Sarcopenia Syndrome for Clinical Outcomes in Hospitalized Patients

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