Abstract
Very little is known about the effect of malnutrition on short-term changes of body composition, particularly muscle, among older hospitalized patients. We sought to investigate the association of malnutrition as assessed by the Global Leadership Initiative on Malnutrition (GLIM) criteria with changes of thigh muscle mass and muscle strength among older patients during hospitalization. Forty-one patients (age range 66–97 years, 73% female) participated in this prospective longitudinal observational study. Nutritional status was evaluated using the GLIM criteria on admission and at discharge. Functional status and mid-thigh magnetic resonance imaging (MRI) measurements of cross-sectional area (CSA) were conducted on admission and before discharge. In all, 17% were malnourished and 83% had no malnutrition. Mean mid-thigh muscle CSA declined by 7.0 cm2 (−9%) in malnourished patients during hospitalization (p = 0.008) and remained unchanged among non-malnourished patients (−1%, p = 0.390). Mean mid-thigh CSA of subcutaneous and intermuscular fat did not change significantly during hospitalization in both groups. Malnourished subjects lost 10% of handgrip strength (−1.8 kg) and 12% of knee extension strength (−1.5 kg) during hospitalization. However, the magnitude of both changes did not differ between groups. In a stepwise multiple regression analysis, malnutrition and changes in body weight during hospitalization were the major independent risk factors for the reduction of muscle CSA. Malnutrition according to the GLIM criteria was significantly and independently associated with acute muscle wasting in frail older patients during 2-week hospitalization.
Highlights
Sarcopenia, which is a consequence of a progressive loss of muscle mass and strength, is common among older adults and contributes to functional decline, increased risk of falls and fractures, and higher morbidity and mortality [1,2]
Of the total population with age range 66–97 years, 17% were malnourished and 83% had no malnutrition according to Global Leadership Initiative on Malnutrition (GLIM) criteria
Further details concerning the prevalence of malnutrition according to MNA-SF can be obtained from Tables 1 and 2
Summary
Sarcopenia, which is a consequence of a progressive loss of muscle mass and strength, is common among older adults and contributes to functional decline, increased risk of falls and fractures, and higher morbidity and mortality [1,2]. Apart from physiological age-associated changes of body composition, other health compromising factors such as acute and chronic disease, disease-related immobilization and malnutrition may further accelerate the development of sarcopenia [4,5]. Immobilization and unintentional bed rest are probably the most important risk factors of hospitalization leading to a reduction of activities of daily living, loss of muscle mass and strength, Nutrients 2020, 12, 1387; doi:10.3390/nu12051387 www.mdpi.com/journal/nutrients. A previous bed rest study among 10 healthy older adults (mean age 67.0 ± 5.0 years) reported 1 kg (6%) muscle mass loss from the lower extremities after 10 days [9]
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