Rehabilitation Nutrition for Iatrogenic Sarcopenia and Sarcopenic Dysphagia

Nagano, Ayano; Nishioka, Shinta; Wakabayashi, Hidetaka

doi:10.1007/s12603-018-1150-1

Cited by 65 publications

(58 citation statements)

References 86 publications

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“…Several studies have reported that hospitalization reduces the muscle mass and strength of older inpatients [14,15], which could have resulted from insufficient nutrition, forced bedrest, and the presence of diseases causing sarcopenia during hospitalization. Some clinicians refer to the hospital-associated decline of muscle mass and strength as iatrogenic sarcopenia [16]. To make matters worse, the sarcopenia condition will further deteriorate in hospitalized patients.…”

Section: Introductionmentioning

confidence: 99%

Development and Predictors of Sarcopenic Dysphagia during Hospitalization of Older Adults

et al. 2019

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The study aimed to investigate the impact of sarcopenia and sarcopenia-related conditions on the development of swallowing disorders during hospitalization. Older adult inpatients (n = 8768) without swallowing disorders in the premorbid period were studied. Sarcopenia-related conditions were evaluated in terms of nutritional status, physical status, and ambulatory conditions as well as hand-grip strength and muscle mass assessed by calf circumference. Development of swallowing disorders was defined based on food texture at discharge from the hospital. The patients’ mean age was 76.1 ± 6.9 years. A total of 374 (4.3%) patients developed swallowing disorders during hospitalization. They were older, with poorer nutritional status, and had more decline of physical performance than those without swallowing disorders. Performance Status score (odds ratio (OR) = 1.28 (1.12–1.46) p < 0.001), ambulatory dependency (OR = 1.72 (1.09–2.71), p = 0.020), malnutrition score (OR = 0.92 (0.87–0.97), p = 0.002), insufficient nutritional intake (OR = 2.33 (1.60–3.40), p < 0.001), and length of stay (OR = 1.01 (1.00–1.01), p = 0.001) were independent contributing factors for swallowing disorder development in the multivariate analysis. The presence of possible sarcopenia was also a contributor to swallowing disorder development. In conclusion, swallowing disorders could develop in patients with possible sarcopenia and sarcopenia-related conditions during hospitalization. Clinicians should be aware of this risk and provide appropriate interventions to prevent sarcopenic dysphagia.

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Section: Introductionmentioning

confidence: 99%

Development and Predictors of Sarcopenic Dysphagia during Hospitalization of Older Adults

et al. 2019

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“…A multimodal approach, including active nutritional therapy and resistance training of the lower extremities, as well as swallowing training and dietary form adjustments, may be effective in the management of sarcopenic dysphagia [34,36]. The rehabilitation nutrition approach [37] is one of the recommended approaches to sarcopenic dysphagia.…”

Section: Discussionmentioning

confidence: 99%

Association of Sarcopenic Dysphagia with Underlying Sarcopenia Following Hip Fracture Surgery in Older Women

et al. 2020

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This study aimed to investigate the association between the development of dysphagia in patients with underlying sarcopenia and the prevalence of sarcopenic dysphagia in older patients following surgical treatment for hip fracture. Older female patients with hip fractures (n = 89) were studied. The data of skeletal muscle mass, hand-grip strength, and nutritional status were examined. The development of dysphagia postoperatively was graded using the Food Oral Intake Scale by a certified nurse in dysphagia nursing. The patients’ mean age was 85.9 ± 6.5 years. The prevalence of sarcopenia was 76.4% at baseline. Of the 89 patients, 11 (12.3%) and 12 (13.5%) had dysphagia by day 7 of hospitalization and at discharge, respectively. All patients who developed dysphagia had underlying sarcopenia. Lower skeletal muscle mass index (SMI) (<4.7 kg/m2) and grip strength (<8 kg) at baseline indicated a higher incidence of dysphagia on day 7 (p = 0.003 and Phi = 0.391) and at discharge (p = 0.001 and Phi = 0.448). Dysphagia developed after hip fracture surgery could be sarcopenic dysphagia, and worsening sarcopenia was a risk factor for dysphagia following hip fracture surgery. Clinicians and medical coworkers should become more aware of the risks of sarcopenic dysphagia. Early detection and preventive interventions for dysphagia should be emphasized.

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“…In these cases, the combination of rehabilitation and nutrition care is called rehabilitation nutrition. In this concept, both rehabilitation and nutrition management is performed together with the International Classification Guidelines on Dysfunction and Health (ICF) to evaluate the subject’s nutritional status and maximize the function of the elderly and disabled [21-23]. Moreover, as nutritional evaluation, intervention, and rehabilitation are performed concurrently; it has been surmised that rehabilitation nutrition is useful for ADL improvement in patients with hip fracture in rehabilitation hospitals.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Performance Improvement in Activities of Daily Living and Energy Intake in Older Patients With Hip Fracture Undergoing Rehabilitation

Umezawa¹,

Kokura

Abe

et al. 2019

Ann Rehabil Med

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Objective To analyze whether sufficient energy intake (EI) improves performance of activities of daily living (ADL) in patients with hip fracture admitted to rehabilitation hospitals. The adequate amount of EI for improving performance of ADL in patients with hip fracture remains unknown. Methods This retrospective cohort study included all patients with hip fracture (n=234) admitted to rehabilitation hospitals in Japan. The inclusion criteria for this study were age >65 years and body mass index <30.0 kg/m 2. Patients who were transferred to an acute hospital and those with missing case data were excluded. According to the amount of EI, the patients were classified into energy sufficiency and shortage groups (EI/total energy expenditure ≥1.0 and <1.0, respectively). The Functional Independence Measure (FIM) and FIM gain were used to evaluate the patient disability level and change in patient status in response to rehabilitation. Finally, FIM gain was calculated as the discharge FIM score minus the admission FIM score. Results The final analysis targeted 202 patients-53 (26.2%) were in the energy shortage group and 149 (73.8%) were in the energy sufficiency group. The energy sufficiency group had a greater FIM gain than the energy shortage group (mean, 25.1±14.2 vs. 19.7±16.4; p=0.024). Furthermore, sufficient EI in the first week since admission (β=0.165; 95% confidence interval, 0.392-5.230; p=0.023) was an independent factor of FIM gain. Conclusion Among elderly patients with hip fracture admitted to rehabilitation hospitals in Japan, the amount of EI during the first week after admission was an independent factor of FIM gain.

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Rehabilitation Nutrition for Iatrogenic Sarcopenia and Sarcopenic Dysphagia

Cited by 65 publications

References 86 publications

Development and Predictors of Sarcopenic Dysphagia during Hospitalization of Older Adults

Development and Predictors of Sarcopenic Dysphagia during Hospitalization of Older Adults

Association of Sarcopenic Dysphagia with Underlying Sarcopenia Following Hip Fracture Surgery in Older Women

Relationship Between Performance Improvement in Activities of Daily Living and Energy Intake in Older Patients With Hip Fracture Undergoing Rehabilitation

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