Abstract
BackgroundAlthough low muscle mass is an important predictor of increased physical morbidity in older patients, information on its impact on mental health and well-being is lacking. The first aim of this report is to look for associations if any between low muscle mass and mental health of older people in clinical practice. The second aim is to study underlying mechanisms including nutritional status.MethodsIn this prospective longitudinal study we randomly selected and studied 432 hospitalized older patients’ baseline demographic data, clinical characteristics and nutritional status on admission, at 6 weeks and at 6 months. Low muscle mass was diagnosed using anthropometric measures based on the European Working Group criteria. Mental health outcome measures including cognitive state, depression symptoms and quality of life were also measured.ResultsOut of 432 patients assessed 44 (10%) were diagnosed with low muscle mass. Patients diagnosed with low muscle mass at admission and over a 6-month follow up period had significantly poor cognitive function, quality of life and increased depression symptoms compared with those with normal muscle mass. After adjustment for poor prognostic indicators, age, disability, severity of acute illness and low muscle mass were associated with poor cognitive function and quality of life and higher depression symptoms in older patients over a 6 months period (p < 0.05). Although patients with low muscle mass had lower micronutrient concentrations compared to those patients with normal muscle mass, only serum albumin showed significant correlations with quality of life at admission and depression symptoms at 6 weeks.ConclusionLow muscle mass is associated with poor blood-borne poor nutritional status and mental health in hospitalized older patients, however, this is partly explained by underlying co morbidity.
Highlights
Low muscle mass is an important predictor of increased physical morbidity in older patients, information on its impact on mental health and well-being is lacking
Despite growing evidence that low muscle mass is common and associated with increasing morbidity and mortality in older people, there is a lack of good-quality data of the effect of low muscle mass diagnosis on mental health and quality of life measures and their response to treatment [1,2,3]
Patients with low muscle mass at admission and at 6 weeks and 6 months follow up had significantly poor cognitive function, quality of life and/or increased depression symptoms compared with patients with normal muscle mass (Figs. 1, 2 and 3)
Summary
Low muscle mass is an important predictor of increased physical morbidity in older patients, information on its impact on mental health and well-being is lacking. Postulated common underlying pathophysiological mechanisms linking changes in muscle mass with poor mental health and well-being include inflammation, oxidative stress, malnutrition and physical inactivity all are common and associated with ill health in older people [6]. We have recently reported that poor muscle strength in hospitalized older people is associated with poor physical and mental health [8]. A recent study reported that poor muscle mass but not poor strength is associated with malnutrition in hospitalized older patients at admission [7]. Given the known link between malnutrition and poor mental health, the aim of this report is to present data on the relationship between low muscle mass, mental health and quality of life and underlying blood-borne nutritional status in hospitalized older patients
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