Quality of life, hospitalisation and sarcopenia among the elderly: a systematic review

Abstract

With the increasing aging population, sarcopenia may become a major issue that requires special attention among healthcare providers. Sarcopenia is a Introduction. Sarcopenia has been demonstrated to affect the quality of life (QoL) of hospitalised elderly. However, no convincing evidence for the best method for measuring sarcopenia in hospitalised elderly is available. The current review aims to investigate the common outcome measures used to measure QoL and sarcopenia in hospitalised elderly. Method. A systematic search of the literature was conducted manually and by using databases, such as Scopus, Web of Science, and PubMed, with various search terms, such as "quality of life," "health-related quality of life", "elderly", "older persons", "sarcopenia", and "sarcopenic". Two researchers independently assessed the studies for eligibility. Studies included in the review were written in the English language and indexed journals published between 2015 and 2019. Results. A total of 400 studies were retrieved; among which, 5 articles were included in the review. The review found that various sarcopenia measures were applied as follows: two studies, skeletal muscle index; one study, muscle cross-sectional area; one study, SARC-F (sluggishness, assistance in walking, rise from a chair, climb stairs, falls) questionnaire; and one study, the algorithm of the European Working Group for Sarcopenia in Older People. The outcome measures for QoL that were used in the studies included the 36-item short-form survey, EuroQoL-5 dimension, Kidney Disease Quality of Life-Short Form, and CASP-12 (control, autonomy, self-realization, pleasure) scale. Mixed results were found in the relationship of QoL with hospitalisation and sarcopenia. Conclusions. Inconsistent findings were found for the relationship between QoL and sarcopenia probably because of the different measures used to assess sarcopenia and QoL of the elderly. The results highlight the importance of conducting a further study on QoL among the elderly with sarcopenia, particularly those who were hospitalised using the currently recommended tool for assessing sarcopenia. Such research may promote patient-centered care and improve QoL by incorporating the concept of QoL into geriatric rehabilitation.

Delirium in hip fractured patients

“…Moreover, the reduction in muscle mass in sarcopenic patients might modify the distribution volumes of hydrophilic drugs, with a higher risk of adverse drug reactions, including druginduced delirium. Of note, elevated blood concentrations of inflammatory cytokines were found in sarcopenic patients, as well as in patients with delirium, suggesting the presence of an inappropriate inflammatory response in both syndromes 17,18 . In particular, some studies reported higher level of C-Reactive Protein (CRP) in patients with sarcopenia without any differences for IL-6 and TNF-a concentration compared to non-sarcopenic patients 17 .…”

“…Of note, elevated blood concentrations of inflammatory cytokines were found in sarcopenic patients, as well as in patients with delirium, suggesting the presence of an inappropriate inflammatory response in both syndromes 17,18 . In particular, some studies reported higher level of C-Reactive Protein (CRP) in patients with sarcopenia without any differences for IL-6 and TNF-a concentration compared to non-sarcopenic patients 17 . Contrary, in other researches the serum levels of TNF-α were found higher in sarcopenia individuals 17 .…”

“…In particular, some studies reported higher level of C-Reactive Protein (CRP) in patients with sarcopenia without any differences for IL-6 and TNF-a concentration compared to non-sarcopenic patients 17 . Contrary, in other researches the serum levels of TNF-α were found higher in sarcopenia individuals 17 . TNF-α is a pro-inflammatory cytokine involved in muscle degradation process and responsible for the production of other cytokines with the consequent systemic inflammatory response.…”