Association between malnutrition and stages of sarcopenia in geriatric rehabilitation inpatients: RESORT

L.M.G Verstraeten,J.P Van Wijngaarden,J Pacifico,E.M Reijnierse,C.G.M Meskers,A.B Maier

doi:10.1016/j.clnu.2021.02.007

Abstract

Malnutrition and sarcopenia coexist in older adults, yet they remain largely undiagnosed and untreated, despite available interventions. This study aimed to assess the prevalence, the coexistence of, and the association between malnutrition and sarcopenia in geriatric rehabilitation inpatients. REStORing health of acutely unwell adulTs (RESORT) is an observational, longitudinal cohort of geriatric rehabilitation inpatients. The association between malnutrition, diagnosed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria and sarcopenia according to the revised definition of the European Working Group on Sarcopenia in Older People (EWGSOP2) (no sarcopenia, probable sarcopenia, confirmed sarcopenia and severe sarcopenia) was determined using multinomial logistic regression analyses, adjusted for age, sex, comorbidities and cognitive impairment. Out of 506 geriatric rehabilitation inpatients, 51% were malnourished, 49% had probable sarcopenia, 0.4% had confirmed sarcopenia (non-severe) and 19% had severe sarcopenia. Malnutrition and probable sarcopenia and malnutrition and confirmed/severe sarcopenia coexisted in 23% and 13% of the 506 patients respectively. Malnutrition was not associated with probable sarcopenia (OR=0.91, 95% CI=0.58-1.42, p=0.674) but with severe sarcopenia (OR=2.07, 95% CI=1.13-3.81, p=0.019). The prevalence, coexistence of, and the association between malnutrition and severe sarcopenia in geriatric rehabilitation inpatients warrant diagnosis at admission. Further research into feasible and effective interventions to counteract both conditions to improve geriatric rehabilitation outcomes is needed.

Highlights

Geriatric rehabilitation following an acute event aims at functional recovery through multidisciplinary interventions [1]
Of the 995 patients admitted, 152 patients were excluded and 150 refused to consent; wave 1 of REStORing health of acutely unwell adulTs (RESORT) included 693 patients, of which 506 were included in the present analysis based on data availability of malnutrition and sarcopenia diagnosis according to the Global Leadership Initiative on Malnutrition (GLIM) criteria and EWGSOP2 definition (Fig. 1)
The prevalence and coexistence of malnutrition according to GLIM and sarcopenia stages according to EWGSOP2 was high among geriatric rehabilitation inpatients

Summary

Introduction

Geriatric rehabilitation following an acute event aims at functional recovery through multidisciplinary interventions [1]. Malnutrition and sarcopenia are independently associated with functional decline [6,7], lower quality of life [8,9] and higher mortality [10,11] in older adults and can negatively impact functional recovery during geriatric rehabilitation [12,13] Both conditions may coexist in geriatric rehabilitation patients [14,15] but they remain largely undiagnosed and untreated in routine clinical care [16e18] despite available interventions, such as resistance exercise training in combination with nutritional interventions [19,20]. The association between malnutrition, diagnosed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria and sarcopenia according to the revised definition of the European Working Group on Sarcopenia in Older People (EWGSOP2) (no sarcopenia, probable sarcopenia, confirmed sarcopenia and severe sarcopenia) was determined using multinomial logistic regression analyses, adjusted for age, sex, comorbidities and cognitive impairment.

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Methods

Results

Discussion

Conclusion