Abstract
BackgroundSarcopenia, frailty, cachexia and malnutrition are widespread syndromes in older people, characterized by loss of body tissue and related to poor outcome. The aim of the present cross-sectional study was to assess the prevalence of these syndromes and their overlap in older medical inpatients.MethodsPatients aged 70 years or older who had been admitted to the internal medical department of a German university hospital were recruited. Sarcopenia, frailty, cachexia and malnutrition were assessed in a standardized manner according to current consensus definitions. Prevalence rates of these syndromes and their constituents and the concurrent occurrence of the syndromes (overlap) were calculated.ResultsOne hundred patients (48 female) aged 76.5 ± 4.7 years with a BMI of 27.6 ± 5.5 kg/m2 were included. The main diagnoses were gastroenterological (33%) and oncological diseases (31%). Sarcopenia was present in 42%, frailty in 33%, cachexia in 32% and malnutrition in 15% of the patients. 63% had at least one syndrome: 32% one, 11% two, 12% three and 8% all four. All four syndromes are characterized by significant weight loss during the last 12 months, which was most pronounced in malnourished patients and least pronounced in frail patients, and by significantly reduced physical performance. All syndromes were significantly pairwise related, except malnutrition and frailty. In 19% of patients sarcopenia and frailty occurred concurrently, in 20% frailty and cachexia and in 22% sarcopenia and cachexia with or without additional other syndromes. All malnourished patients except one were also cachectic (93%) and 80% of malnourished patients were also sarcopenic. 53% of malnourished patients were in addition frail, and these patients were affected by all four syndromes.ConclusionsNearly two thirds of older medical inpatients had at least one of the tissue loss syndromes sarcopenia, frailty, cachexia and malnutrition. The syndromes overlapped partly and were interrelated. Future studies with larger patient groups and longitudinal design are required to clarify the significance of single and concurrent occurrence of these syndromes for clinical outcome and successful therapy.
Highlights
Sarcopenia, frailty, cachexia and malnutrition are widespread syndromes in older people and associated with an increased risk of poor outcome like mobility limitation, fracture, increased length of hospital stay, hospital readmission, morbidity and mortality [1,2,3,4]
Frailty and cachexia the loss of fat-free mass, especially skeletal muscle mass, is crucial [10,11,12], in malnutrition fat free mass as well as fat mass are reduced [13]. Besides these changes in body composition, all syndromes except malnutrition are characterized by specific additional features: sarcopenia and frailty by reduced strength and function [10, 11], frailty in addition by exhaustion and low physical activity [11], and cachexia by reduced strength, fatigue, anorexia and inflammation [12]
Cognitive status was rated with the Mini-Mental State Examination (MMSE) [22]
Summary
Sarcopenia, frailty, cachexia and malnutrition are widespread syndromes in older people and associated with an increased risk of poor outcome like mobility limitation, fracture, increased length of hospital stay, hospital readmission, morbidity and mortality [1,2,3,4]. Frailty and cachexia the loss of fat-free mass, especially skeletal muscle mass, is crucial [10,11,12], in malnutrition fat free mass as well as fat mass are reduced [13] Besides these changes in body composition, all syndromes except malnutrition are characterized by specific additional features: sarcopenia and frailty by reduced strength and function [10, 11], frailty in addition by exhaustion and low physical activity [11], and cachexia by reduced strength, fatigue, anorexia and inflammation [12]. Sarcopenia, frailty, cachexia and malnutrition are widespread syndromes in older people, characterized by loss of body tissue and related to poor outcome. The aim of the present cross-sectional study was to assess the prevalence of these syndromes and their overlap in older medical inpatients
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