Skip to main content

Advertisement

SpringerLink
Log in

Risk of sarcopenia in hospitalized patients and related clinical factors: a multicenter study from Turkey

  • Research Paper
  • Published:
European Geriatric Medicine Aims and scope Submit manuscript

Key summary points

AbstractSection Aim

To evaluate sarcopenia risk in hospitalized older patients.

AbstractSection Findings

The percentage of patients at risk of sarcopenia defined by the SARC-F was 48.8%. Sarcopenia risk was associated with unfavorable health care outcomes including dependency, malnutrition, and dysphagia.

AbstractSection Message

Sarcopenia risk is related with unfavorable outcomes in hospitalized patients and it is important to recognize sarcopenia at an early stage and to prevent its progression, before dependency develops.

Abstract

Purpose

To investigate the risk of sarcopenia in hospitalized older patients and to assess the associations between sarcopenia risk and health care outcomes including dependency, malnutrition, and dysphagia.

Methods

This multicenter cross-sectional study was a part of the annual National Prevalence Measurement of Quality of Care (LPZ) in Turkey. Hospitalized patients age 65 and older were included in the study. The SARC-F was used to assess risk of sarcopenia. Dependency was appraised according to the Care Dependency Scale (CDS). Nutritional status was established with respect to the Malnutrition Universal Screening Tool (MUST). Dysphagia was screened by two structured questions.

Results

A total of 492 patients were included in the analysis. Two hundred and forty patients (48.8%) were at risk of sarcopenia. Sarcopenia risk was more prevalent among women (p = 0.007) and patients with risk of sarcopenia were older (p < 0.001). Hospital stay was longer and malnutrition and dysphagia were more prevalent in patients with sarcopenia risk than without (all p < 0.001). All nutritional interventions were applied mostly to patients with sarcopenia risk than without. In multivariate analysis, advanced age (OR: 1.068, CI 1.032–1.104, p < 0.001), female gender (OR: 2.414, CI 1.510–3.857, p < 0.001), and dependency (OR: 5.022, CI 2.922–8.632, p < 0.001) were independently associated with sarcopenia risk.

Conclusions

Sarcopenia risk is related with unfavorable outcomes in hospitalized patients. Primarily older female patients are at risk for sarcopenia. It is important to recognize sarcopenia at an early stage and to prevent its progression, before dependency develops. The SARC-F may be a useful tool for screening sarcopenia risk in hospitalized patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing 39:412–423

    Article  Google Scholar 

  2. Cao L, Chen S, Zou C et al (2014) A pilot study of the SARC-F scale on screening sarcopenia and physical disability in the Chinese older people. J Nutr Health Aging 18:277–283

    Article  CAS  Google Scholar 

  3. Cao L, Morley JE (2016) Sarcopenia is recognized as an independent condition by an international classification of disease, tenth revision, clinical modification (ICD-10-CM) code. J Am Med Dir Assoc 17:675–677

    Article  Google Scholar 

  4. Borges TC, Gomes TLN, Pimentel GD (2019) Sarcopenia as a predictor of nutritional status and comorbidities in hospitalized patients with cancer: a cross-sectional study. Nutrition 73:110703

    Article  Google Scholar 

  5. Cruz-Jentoft AJ, Bahat G, Bauer J et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48:16–31

    Article  Google Scholar 

  6. Malmstrom TK, Miller DK, Simonsick EM, Ferrucci L, Morley JE (2016) SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle 7:28–36

    Article  Google Scholar 

  7. Bahat G, Yilmaz O, Kılıç C, Oren M, Karan MA (2018) Performance of SARC-F in regard to sarcopenia definitions, muscle mass and functional measures. J Nutr Health Aging 22:898–903

    Article  CAS  Google Scholar 

  8. Bastijns S, Bauer J, Cruz-Jentoft AJ et al. Acute sarcopenia in hospitalized elderly: assessment through ultrasound. clinicaltrials.gov

  9. Gariballa S, Alessa A (2013) Sarcopenia: prevalence and prognostic significance in hospitalized patients. Clin Nutr 32:772–776

    Article  Google Scholar 

  10. Morandi A, Onder G, Fodri L et al (2015) The association between the probability of sarcopenia and functional outcomes in older patients undergoing in-hospital rehabilitation. J Am Med Dir Assoc 16:951–956

    Article  Google Scholar 

  11. Vetrano DL, Landi F, Volpato S, Corsonello A, Meloni E, Bernabei R, Onder G (2014) Association of sarcopenia with short- and long-term mortality in older adults admitted to acute care wards: results from the CRIME study. J Gerontol A Biol Sci Med Sci 69:1154–1161

    Article  Google Scholar 

  12. Tang T, Wu L, Yang L et al (2018) A sarcopenia screening test predicts mortality in hospitalized older adults. Sci Rep 8:2923

    Article  Google Scholar 

  13. Yoshimura Y, Wakabayashi H, Bise T, Tanoue M (2018) Prevalence of sarcopenia and its association with activities of daily living and dysphagia in convalescent rehabilitation ward inpatients. Clin Nutr 37:2022–2028

    Article  Google Scholar 

  14. van Nie-Visser NC, Schols JM, Meesterberends E, Lohrmann C, Meijers JM, Halfens RJ (2013) An international prevalence measurement of care problems: study protocol. J Adv Nurs 69:e18-29

    Article  Google Scholar 

  15. Dijkstra A, Hakverdioğlu G, Korhan EA, Muszalik M, Kędziora-Kornatowska K, Suzuki M (2012) The care dependency scale for measuring basic human needs: an international comparison. J Adv Nurs 68:2341–2816

    Article  Google Scholar 

  16. Stratton RJ, Hackston A, Longmore D et al (2004) Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the ‘malnutrition universal screening tool’ (‘MUST’) for adults. Br J Nutr 92:799–808

    Article  CAS  Google Scholar 

  17. Huppertz VAL, Halfens RJG, van Helvoor A et al (2018) Association between oropharyngeal dysphagia and malnutrition in Dutch nursing home residents: results of the national prevalence measurement of quality of care. J Nutr Health Aging 22:1246–1252

    Article  CAS  Google Scholar 

  18. Tanaka S, Kamiya K, Hamazaki N et al (2017) Utility of SARC-F for assessing physical function in elderly patients with cardiovascular disease. J Am Med Dir Assoc 18:176–181

    Article  Google Scholar 

  19. Ozsurekci C, Arslan SS, Demir N et al (2020) Timing of dysphagia screening in Alzheimer’s dementia. JPEN J Parenter Enter Nutr 44:516–524

    Article  CAS  Google Scholar 

  20. Lee WJ, Liu LK, Peng LN, Lin MH, Chen LK, ILAS Research Group et al (2013) Comparisons of sarcopenia defined by IWGS and EWGSOP criteria among older people: results from the I-Lan longitudinal aging study. J Am Med Dir Assoc 14:528.e1–7

    Google Scholar 

  21. Ishii S, Tanaka T, Shibasaki K et al (2014) Development of a simple screening test for sarcopenia in older adults. Geriatr Gerontol Int 14:93–101

    Article  Google Scholar 

  22. Wu CH, Chen KT, Hou MT et al (2014) Prevalence and associated factors of sarcopenia and severe sarcopenia in older Taiwanese living in rural community: the Tianliao Old People study 04. Geriatr Gerontol Int 14:69–75

    Article  Google Scholar 

  23. Wu Y-H, Hwang A-C, Liu L-K et al (2016) Sex differences of sarcopenia in Asian populations: the implications in diagnosis and management. J Clin Gerontol Geriatr 7:37–43

    Article  CAS  Google Scholar 

  24. Kingston A, Wohland P, Wittenberg R et al (2017) Is late-life dependency increasing or not? A comparison of the Cognitive Function and Ageing Studies (CFAS). Lancet 390:1676–1684

    Article  Google Scholar 

  25. Yoshimura Y, Wakabayashi H, Bise T et al (2019) Sarcopenia is associated with worse recovery of physical function and dysphagia and a lower rate of home discharge in Japanese hospitalized adults undergoing convalescent rehabilitation. Nutrition 61:111–118

    Article  Google Scholar 

  26. Janssen I, Shepard DS, Katzmarzyk PT, Roubenoff R et al (2004) The healthcare costs of sarcopenia in the United States. J Am Geriatr Soc 52:80–85

    Article  Google Scholar 

  27. Fırat Ozer F, Akın S, Soysal T, Gokcekuyu BM, Erturk ZG (2021) Relationship between dysphagia and sarcopenia with comprehensive geriatric evaluation. Dysphagia 36:140–146

    Article  Google Scholar 

  28. Cerri AP, Bellelli G, Mazzone A, Pittella F, Landi F, Zambon A, Annoni G (2015) Sarcopenia and malnutrition in acutely ill hospitalized elderly: prevalence and outcomes. Clin Nutr 34:745–751

    Article  Google Scholar 

  29. Jyväkorpi SK, Ramel A, Strandberg TE et al (2021) The sarcopenia and physical frailty in older people: multi-component treatment strategies (SPRINTT) project: description and feasibility of a nutrition intervention in community-dwelling older Europeans. Eur Geriatr Med. https://doi.org/10.1007/s41999-020-00438-4

    Article  PubMed  PubMed Central  Google Scholar 

  30. Martínez-Velilla N, Casas-Herrero A, Zambom-Ferraresi F et al (2019) Effect of exercise intervention on functional decline in very elderly patients during acute hospitalization: a randomized clinical trial. JAMA Intern Med 179:28–36

    Article  Google Scholar 

  31. Kera T, Kawai H, Hirano H et al (2020) Limitations of SARC-F in the diagnosis of sarcopenia in community-dwelling older adults. Arch Gerontol Geriatr 87:103959

    Article  Google Scholar 

  32. Li M, Kong Y, Chen H, Chu A, Song G, Cui Y (2019) Accuracy and prognostic ability of the SARC-F questionnaire and Ishii’s score in the screening of sarcopenia in geriatric inpatients. Braz J Med Biol Res 52:e8204

    Article  Google Scholar 

  33. Yu SC, Khow KS, Jadczak AD, Visvanathan R (2016) Clinical screening tools for sarcopenia and its management. Curr Gerontol Geriatr Res 2016:5978523

    Article  Google Scholar 

Download references

Acknowledgements

We would like to thank Prof. FehmiAkcicek (Division of Geriatrics, Department of Internal Medicine, School of Medicine, Ege University, Izmir, Turkey), Prof. TeslimeAtlı (Guven Hospital, Department of Geriatrics, Ankara, Turkey), and Meftun Fırtına (Medical Manager, Nutricia, Turkey) for their support.

Funding

This work was supported by Nutricia Turkey. The funding played no role in study design, collection, analysis, interpretation of data, writing the manuscript, or the decision to submit for publication.

Author information

Authors and Affiliations

  1. Department of Geriatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey

    Firuzan Fırat Ozer & Sibel Akin

  2. Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey

    İlker Tasci

  3. Department of Internal Medicine, Atatürk University Faculty of Medicine, Erzurum, Turkey

    Pinar Tosun Tasar

  4. Department of Geriatrics, Ege University Faculty of Medicine, Izmir, Turkey

    Sumru Savas

  5. Department of Geriatrics, Marmara University Faculty of Medicine, Istanbul, Turkey

    Asli Tufan Cincin

  6. Department of Geriatrics, Cerrahpasa University Faculty of Medicine, Istanbul, Turkey

    Hakan Yavuzer & Deniz Suna Erdincler

  7. Department of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey

    Cafer Balci & Mert Esme

  8. Department of Geriatrics, Gaziantep University Faculty of Medicine, Gaziantep, Turkey

    Zeynel Abidin Ozturk

  9. Department of Internal Medicine, Maltepe University Faculty of Medicine, Istanbul, Turkey

    Gulbuz Sezgin & Selim Nalbant

  10. Department of Geriatrics, Ankara University Faculty of Medicine, Ankara, Turkey

    Murat Varli

  11. Department of Geriatrics, İstanbul University Faculty of Medicine, Istanbul, Turkey

    Mehmet Akif Karan & Bülent Saka

  12. Department of Geriatrics, Kayseri City Hospital, Kocasinan, 38080, Kayseri, Turkey

    Firuzan Fırat Ozer

Authors
  1. Firuzan Fırat Ozer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sibel Akin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. İlker Tasci
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pinar Tosun Tasar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sumru Savas
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Asli Tufan Cincin
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hakan Yavuzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Deniz Suna Erdincler
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Cafer Balci
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Mert Esme
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Zeynel Abidin Ozturk
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Gulbuz Sezgin
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Selim Nalbant
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Murat Varli
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Mehmet Akif Karan
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Bülent Saka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Firuzan Fırat Ozer.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Study protocol was approved by the Ethical Committee of the Faculty of Medicine-Istanbul University. ((Decision no: 02/Date:22.01.2016/No:153).

Informed consent

All participants or their proxies signed the informed consent form.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ozer, F.F., Akin, S., Tasci, İ. et al. Risk of sarcopenia in hospitalized patients and related clinical factors: a multicenter study from Turkey. Eur Geriatr Med 12, 863–870 (2021). https://doi.org/10.1007/s41999-021-00499-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s41999-021-00499-z

Keywords

Search

Navigation