A sarcopenia screening test predicts mortality in hospitalized older adults

Tianjiao Tang,Ming Yang,Qiukui Hao,Ling Yang,Birong Dong,Jiaojiao Jiang,Linna Wu

doi:10.1038/s41598-018-21237-9

Abstract

The aim of this study is to investigate the validation of a sarcopenia screening test (Ishii’s formula) for predicting long-term mortality among older adult inpatients. A prospective, observational study was conducted in acute geriatric wards at three hospitals in western China. Sarcopenia was estimated using Ishii’s formula. Survival status was assessed at 12, 24, and 36 months after the baseline investigation. Cox proportional-hazard models were applied to calculate the hazard ratio for mortality associated with sarcopenia. Three hundred and eighty participants (100 women) with a mean age of 80.2 ± 7.1 years were included. According to Ishii’s formula, 264 participants (69.5%) were sarcopenic. The prevalence of sarcopenia was similar in men and women (71.1% vs. 65.0%, respectively, P = 0.258). Sixty-seven participants (17.6%) died during the 3-year follow-up period. The all-cause mortality was significantly higher in the sarcopenia group than in the non-sarcopenia group (20.1% vs. 12.1%, respectively, P < 0.05). Multivariate Cox proportional hazards analysis identified sarcopenia as a significant predictor of 3-year all-cause mortality (adjusted hazard ratio [HR]: 2.06; 95% confidence interval [CI]: 1.02–4.15). In conclusion, sarcopenia, estimated by Ishii’s formula, can predict 3-year all-cause mortality in a study population of hospitalized older adults.

Highlights

Sarcopenia is a geriatric syndrome characterized by a loss of muscle mass, strength, and function[1]
A total of 451 participants agreed to participate in the baseline investigation; 71 of them were excluded from the study because of severe cognitive impairment (12 individuals), delirium (8 individuals), edema (12 individuals), or with missing data (39 individuals)
Twenty-seven participants were lost to follow-up during the 3-year period, resulting in a final sample size of 353 participants (Fig. 1)

Summary

Introduction

Sarcopenia is a geriatric syndrome characterized by a loss of muscle mass, strength, and function[1]. Sarcopenia has been associated with an increased risk of many adverse events, such as functional decline, falls, disability, poor quality of life and increased mortality[4,5,6,7] Interventions, such as resistance exercise and nutritional supplements, can effectively slow the progression of sarcopenia and prevent physical disability[8,9,10]. Unlike the SARC-F, Ishii’s formula was only based on age, calf circumference (CC) and handgrip strength (HS), which are easy to perform in clinical practice. It had reasonable sensitivity and specificity with a cut-point of 105 for older women (Sensitivity 75.5%, Specificity 92.0%) and 120 for older men (Sensitivity 84.9%, Specificity 88.2%). We conducted a prospective study to investigate the prevalence of sarcopenia defined using Ishii’s formula and to evaluate whether this estimation of sarcopenia can predict long-term mortality among a study population of hospitalized older adults

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Discussion

Conclusion