Impact of poor muscle strength on clinical and service outcomes of older people during both acute illness and after recovery

Salah Gariballa,Awad Alessa

doi:10.1186/s12877-017-0512-6

Salah Gariballa, Awad Alessa

Open Access

https://doi.org/10.1186/s12877-017-0512-6

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Abstract

BackgroundAlthough Low muscle strength is an important predictor of functional decline in older people, however information on its impact on clinical and service outcomes in acute care settings is still lacking. The aim of this study is to measure the impact of low muscle strength on clinical and service outcomes in older adults during both acute illness and recovery.MethodsRandomly selected 432 hospitalised older patients had their clinical characteristics and nutritional status assessed within 72 h of admission, at 6 weeks and at 6 months. Low muscle strength-hand grip was defined using the European Working Group criteria. Health outcome measures including nutritional status, length of hospital stay, disability, discharge destination, readmission and mortality were also measured.ResultsAmong the 432 patients recruited, 308 (79%) had low muscle strength at baseline. Corresponding figures at 6 weeks and at 6 months were 140 (73%) and 158 (75%). Patients with poor muscle strength were significantly older, increasingly disabled, malnourished and stayed longer in hospital compared with those with normal muscle strength. A significantly higher number of patients with normal muscle strength discharged home independently compared with those with poor muscle strength (p < 0.05). One-year death rate was lower in patients with normal muscle strength 5(6%), compared with those with poor muscle strength 52(15%), however, results were not statistically significant after adjusting for other poor prognostic indicators [adjusted hazard ratio 0.74 (95% CI: 0.14–3.87), p = 0.722].ConclusionPoor muscle strength in older people is associated with poor clinical service outcomes during both acute illness and recovery.

Highlights

Low muscle strength is an important predictor of functional decline in older people, information on its impact on clinical and service outcomes in acute care settings is still lacking
Recurrent ill health is more common in older people and that inflammatory response during acute illness leads to a state of negative nitrogen balance resulting in significant loss of muscle mass
Patients with poor muscle strength were significantly older with increased disability and poor nutritional status compared with those with normal muscle strength (Table 1)

Summary

Introduction

Low muscle strength is an important predictor of functional decline in older people, information on its impact on clinical and service outcomes in acute care settings is still lacking. Ageing in man is associated with physiological and pathological changes many of which have impact on treatment and prevention of disease and maintenance of good health Both muscle strength and mass deteriorate with ageing and are known to be associated with disability in later life [1,2,3]. Longitudinal studies have revealed that decline in muscle strength in older people far exceeds the observed changes in muscle mass and that treatments that maintain or increase muscle mass may not necessarily decrease or prevent muscle weakness in later life [6, 7]. Knowledge of underlying causes and health impact of poor muscle strength is expected to help guide

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