The association between malnutrition and sarcopenia-related indicators at admission and functional prognosis in acute stroke patients aged over 80 years

Tomoyuki Ogino, Masafumi Nozoe, Tatsuro Inoue, Kazuki Okuda, Satoshi Kumagai, Naoki Kida, Kiminori Matushita, Kenta Yamamoto
Purpose:

The purpose of this study is to clarify the association between malnutrition and sarcopenia-related indicators at admission on the functional prognosis three months after the stroke in patients aged over 80 years.

Methods:

The patients were stroke patients aged 80 and over, who were hospitalized between November 2020 and May 2023, including those with cerebral infarction and cerebral hemorrhage. Within five days of admission, malnutrition was assessed using Body Mass Index (BMI) and the Mini Nutritional Assessment Short Form (MNA-SF), while sarcopenia risk was evaluated by measuring calf circumference and handgrip strength. We classified as low BMI if BMI 20 (for those aged over 70) or BMI 18.5 (for those under 70) and at risk of malnutrition if MNA-SF 11 points. In addition, we classified as low muscle mass if calf circumference 34 cm for men and 33 cm for women, as low muscle strength if handgrip strength 28 kg for men and 18 kg for women. The outcome was measured by the modified Rankin Scale (mRS) three months after the stroke, and patients were defined as having a poor functional prognosis if their mRS was ≥3 or did not improve to their pre-stroke mRS. Statistical analysis was performed using a multivariate logistic regression model, with poor functional prognosis as the dependent variable, and age, gender, stroke subtype, NIH Stroke Scale score, and recanalization therapy as confounding factors, in addition to low BMI, malnutrition risk, low muscle mass, and low muscle strength as explanatory variables.

Results:

A total of 180 old acute stroke patients [median age 86 (interquartile range: 84-90) years] were included in the analysis, with 114 (63%) classified as having a poor functional prognosis. Among the four adjusted models, low muscle strength (adjusted odds ratio = 6.57, 95% confidence interval: 1.54-45.71, p = 0.023) was independently associated with poor functional prognosis three months after stroke onset. However, no significant association was found between low BMI, malnutrition risk, and low muscle mass.

Conclusion(s):

The importance of early muscle strength assessment in old acute stroke patients was suggested.

Implications:

The results of this study enable more accurate prognoses and targeted interventions for old acute stroke patients.

Funding acknowledgements:
No funding was received.
Keywords:
acute stroke
geriatric syndromes
functional prognosis
Primary topic:
Neurology: stroke
Second topic:
Older people
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
This study was conducted with the approval of the Konan Medical Center Ethics Committee.
Provide the ethics approval number:
2020-12
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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