Sarcopenia in older adults admitted to acute medical unit: a prospective observational study of feasibility and clinical outcomes

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Background Sarcopenia, the loss of skeletal muscle mass and function, has recently emerged as a significant health concern. It is common in older adults and linked to poor outcomes. It is dynamic and can improve or deteriorate over short periods of time. We aimed to determine its prevalence and changes during hospital admission and explore associations with clinical outcomes. Methods This was a Prospective, Observational Cohort, Feasibility Study. Older Adults (>65 years old) with an unplanned admission to an AMU in a secondary care hospital were eligible to participate in the study. Muscle mass was measured using an ultrasound, handgrip strength using a hand-held dynamometer and 4 meters gait speed on admission, at day 3 and day 7. Outcomes were assessed up to 3 months, and we recorded mortality at 6 months. Results A total of 106 patients were recruited from 232 screened. Only 18 participants completed 3-month follow up although 6-month mortality was recorded for all participants. Mean (SD) age at admission was 76.8 years (7.0); 56% were female and 97.2% White. Sarcopenia prevalence was 60.4% on admission. Patients with Sarcopenia were nearly 6 times (OR 5.94, 95% CI 1.66–28.6) more likely to die within 6 months, including when adjusted for nutritional status and hemoglobin. Low muscle mass, strength, and gait speed, as individual factors on admission, were also associated with 6-month mortality (Correlation co-efficient R = −0.67, p < 0.001; R = −0.76, p < 0.001 and R = −0.54, p < 0.001, respectively). Longitudinal data were limited due to study withdrawal and exploratory sarcopenia trajectories varied across individuals who remained in the study. Conclusion Sarcopenia is highly prevalent among older adults acutely admitted to hospital; and although worse health outcomes, including mortality, were observed in those with sarcopenia, these findings are exploratory. Delivering longitudinal research in this population remains challenging, particularly due to high withdrawal rates in less robust adults.

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