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The association between sarcopenia and functional outcomes among older patients with hip fracture undergoing in-hospital rehabilitation

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Abstract

Summary

This study evaluates the prevalence of sarcopenia among older people admitted to a rehabilitation unit after hip fracture and the association between sarcopenia and functional outcomes. The results show that sarcopenia had a negative impact on functional recovery. The assessment of sarcopenia among older adults receiving rehabilitation programs is crucial.

Introduction

Sarcopenia is a highly prevalent geriatric syndrome associated with adverse outcomes, including falls, disability, institutionalization, and mortality. Few studies assessed sarcopenia among older adults receiving rehabilitation programs.

Methods

Patients aged 70 years or more consecutively admitted to in-hospital rehabilitation programs that had suffered from hip fracture entered the study. Sarcopenia was defined according to the Foundation for National Institutes of Health (FNIH) criteria. Multivariable linear regression models were used to analyze the association between the sarcopenia and functional recovery.

Results

The recruited population was composed of 127 patients, with a mean age of 81.3 ± 4.8 years, predominantly females (64.6%). Using the criteria proposed by the FNIH, patients with a diagnosis of sarcopenia were 43 (33.9%). After adjustment for potential confounders, participants with sarcopenia had a significant increased risk of incomplete functional recovery compared with non-sarcopenic patients (OR 3.07, 95% CI 1.07–8.75). Compared with participants without sarcopenia, those with sarcopenia showed lower Barthel index scores at the time of discharge from the rehabilitation unit (69.2 versus 58.9, respectively; p < 0.001) and after 3 months of follow-up (90.9 versus 80.5, respectively; p = 0.02).

Conclusions

These findings support the systematic assessment of sarcopenia among older adults receiving rehabilitation programs to assist in the development of personalized treatment plans aimed at improving functional outcomes.

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Acknowledgments

The study was partly supported by intramural research grants from the Catholic University of the Sacred Heart (D3.2 2013 and D3.2 2015), IMI-JU (# 115621), Fondazione Roma (NCDs Call for Proposals 2013, and the “Centro Studi Achille e Linda Lorenzon”.

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Authors and Affiliations

  1. Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy

    F. Landi, R. Calvani, E. Ortolani, S. Salini, A. M. Martone, A. Sisto, A. Picca & E. Marzetti

  2. Center for Geriatric Medicine (CEMI), Institute of Internal Medicine and Geriatrics, Catholic University of the Sacred Heart, L.go F. Vito 8, 00168, Rome, Italy

    F. Landi

  3. Department of Medicine, Catholic University of the Sacred Heart, Rome, Italy

    L. Santoro & A. Santoliquido

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  1. F. Landi
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  2. R. Calvani
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  3. E. Ortolani
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  4. S. Salini
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  5. A. M. Martone
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  6. L. Santoro
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  8. A. Sisto
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  9. A. Picca
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  10. E. Marzetti
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Corresponding author

Correspondence to F. Landi.

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Conflicts of interest

Emanuele Marzetti, Francesco Landi, and Riccardo Calvani are partners of the SPRINTT Consortium, which is partly funded by the European Federation of Pharmaceutical Industries and Associations (EFPIA). The other authors declare that they have no conflict of interest.

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Landi, F., Calvani, R., Ortolani, E. et al. The association between sarcopenia and functional outcomes among older patients with hip fracture undergoing in-hospital rehabilitation. Osteoporos Int 28, 1569–1576 (2017). https://doi.org/10.1007/s00198-017-3929-z

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  • DOI: https://doi.org/10.1007/s00198-017-3929-z

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