title: Sarcopenia and malnutrition in acutely ill hospitalized elderly: Prevalence and outcomes.
abstract: OBJECTIVE
  Data about the prevalence of sarcopenia among hospitalized patients is lacking and it is unclear whether the diagnostic criteria commonly used in community-dwellers is applicable in acutely ill subjects. The aims of this report are: (i) to assess the prevalence of sarcopenia among hospitalized patients; (ii) to assess whether the European Working Group on Sarcopenia in Older People (EWGSOP) criteria are applicable in an acute care setting; and (iii) to assess the mortality rate at 3 months.
  
  
  METHODS
  103 patients admitted to the Acute Geriatric Clinic were enrolled. Inclusion criteria were: age ≥65 years and malnutrition or risk of malnutrition, according to the Mini Nutritional Assessment Short Form. Sarcopenia was diagnosed using the EWGSOP criteria by means of bioimpedance analysis, handgrip strength and gait speed, within 72 h of admission. Information on deaths was obtained by telephone interview at 3 months following discharge.
  
  
  RESULTS
  Sarcopenia was diagnosed in 22 patients (21.4%). Twenty-three patients (22.3%) were not able to perform the gait speed and/or the handgrip strength because bedridden or requiring intensive treatments. In this group, a definite diagnosis of sarcopenia was not possible, lacking at least one EWGSOP criteria. Eleven (10.7%) patients died within the 3 months post-discharge period. Kaplan-Meier survival curves showed that sarcopenic patients died significantly more frequently than others (log-rank p ≤ 0.001).
  
  
  CONCLUSIONS
  In a population of hospitalized elderly malnourished or at risk of malnutrition, sarcopenia is highly prevalent and associated with an increased risk to die in the short-term. Furthermore, the EWGSOP criteria cannot be satisfactorily applied in a relevant proportion of patients.
authors.affiliation: Department of Health Sciences, University of Milano-Bicocca, Italy.
authors.forename: Anna Paola
authors.initials: AP
authors.lastname: Cerri
authors.affiliation: Department of Health Sciences, University of Milano-Bicocca, Italy; Geriatric Clinic, San Gerardo Hospital, Monza, Italy; Milan Center for Neuroscience (Neuro-Mi), Milan, Italy. Electronic address: giuseppe.bellelli@unimib.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bellelli
authors.affiliation: Department of Health Sciences, University of Milano-Bicocca, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Mazzone
authors.affiliation: Department of Health Sciences, University of Milano-Bicocca, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Pittella
authors.affiliation: Department of Gerontology and Geriatrics, Catholic University of Sacred Heart, Roma, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Landi
authors.affiliation: Department of Statistics and Quantitative Methods, Unit of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Milano, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Zambon
authors.affiliation: Department of Health Sciences, University of Milano-Bicocca, Italy; Geriatric Clinic, San Gerardo Hospital, Monza, Italy; Milan Center for Neuroscience (Neuro-Mi), Milan, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Annoni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000628:therapy*; D017097:Electric Impedance; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology; D015577:Geriatric Assessment; D018737:Hand Strength; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D044342:Malnutrition / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D055948:Sarcopenia / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D016896:Treatment Outcome
keywords: EWGSOP criteria; Elderly; Hospital; Mortality; Sarcopenia