Authors (including presenting author) :
SIN YW(1), TAM SKF(2), TONG MC(1), POON MWY(1)
Affiliation :
(1)Physiotherapy Department, Hong Kong Buddhist Hospital, (2)Department of Medicine, Hong Kong Buddhist Hospital
Introduction :
Sarcopenia is age-related progressive generalized reduction of skeletal muscle mass, strength, and/or function. Sarcopenia is associated with fall, hospitalization, frailty, and mortality. Early identification is crucial for prompt interventions for decelerating and potentially reversing sarcopenia.
Objectives :
(1)To investigate the associations between sarcopenia and physical outcomes in medical rehabilitation settings; (2)to identify a simple clinical screening tool with an optimal cut-off for sarcopenia.
Methodology :
A cross-sectional study design was employed and fifty-one patients admitted to Hong Kong Buddhist Hospital medical wards from May to December 2022 with “deconditioning”, “decreased mobility”, or “limb weakness” were recruited. The inclusion criteria included age ≥60, Modified Functional Ambulation Classification ≥V, and oriented and followed commands. The exclusion criteria included electronic or metal implant, marked orthopaedic or neurovascular, unstable cardiovascular, uncontrolled psychological, or palliative conditions. Outcome measurements were performed within first two weeks of hospitalization. Primary outcomes included Elderly Mobility Scale (EMS), 30-seconds Sit-to-Stand (30s STS), and Timed Up-and-Go (TUG). Secondary outcomes included appendicular skeletal muscle mass index, handgrip strength, isometric quadriceps strength, 6-meters Walk Test, and SARC-F questionnaire. Asian Working Group for Sarcopenia 2019 diagnostic algorithm was followed.
Result & Outcome :
Amongst fifty-one participants (45% males; mean age: 76.63±8.21), 62.7% had severe sarcopenia and 17.6% had sarcopenia, whereas 19.7% had no diagnosis of sarcopenia. For sarcopenic subjects, all primary and secondary outcomes except SARC-F were significantly poorer. Sarcopenia had fair (r=-0.329) to moderate (r=-0.651) correlations with all primary and secondary outcomes except SARC-F. Quadriceps strength(p=0.018, OR=0.699, 95%C.I.=0.521-0.940) and 30s STS (p=0.033, OR=0.604, 95%C.I.=0.381-0.959) were significant predictors for sarcopenia in multivariate logistic regression models adjusted for age and gender. TUG was a significant predictor(p=0.022, OR=1.834, 95%C.I.=1.093–3.077) in the model adjusted for gender. Quadriceps strength with cut-off (15.5 kilogram-force) had excellent accuracy(0.855), moderate sensitivity(0.829), and moderate specificity (0.800). 30s STS with cut-off (10 repetitions) had excellent accuracy(0.871), moderate sensitivity(0.805), and moderate specificity(0.800). TUG with cut-off (14.0 seconds) had excellent accuracy(0.868), moderate sensitivity(0.732), and high specificity(0.900).
Conclusion:
Quadriceps strength, 30-seconds Sit-to-Stand, and Timed Up-and-Go could be used as simple clinical screening tools with excellent diagnostic accuracy and significant logistic regression model for predicting risk of sarcopenia.
