Severely Decreased Muscle Mass among Older Patients Hospitalized in a Long-Term Care Ward in Japan

Abstract

Sarcopenia is known to increase the risk of adverse outcomes, including disability, loss of independence, hospitalization, longer length of hospital stay, and mortality, but there is little data about the prevalence of sarcopenia and the factors associated with increased physical dependency and cognitive decline among older patients hospitalized in a long-term care (LTC) ward in Japan. A cross-sectional study was conducted in 79 consecutive patients (34 men, 45 women) with a median age of 81 y hospitalized in an LTC hospital. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia. Skeletal muscle mass index (SMI) was assessed by using bioelectrical impedance analysis. Physical dependency and cognitive decline were evaluated by the Functional Independence Measure (FIM). Nutritional status was evaluated by using the Mini Nutritional Assessment-Short Form and daily intake of energy and protein. Multivariate analyses were applied to examine factors associated with increased physical dependency and cognitive decline. Median SMI was 4.9 kg/m² (interquartile range [IQR], 4.0-5.3 kg/m²) in men and 3.3 kg/m² (IQR, 2.9-3.8 kg/m²) in women, showing that all participants had an SMI below the cut-off value. Seventy participants (88.6%) were unable to perform the hand grip strength test, and all participants were unable to perform the gait speed test. Multivariate analysis showed that oral nutritional access and daily energy intake were associated both with physical and cognitive level (p<0.05).