title: Functional performance, nutritional status, and body composition in ambulant community-dwelling individuals 1-3 years after suffering from a cerebral infarction or intracerebral bleeding.
abstract: BACKGROUND
  Muscle wasting and obesity may complicate the post-stroke trajectory. We investigated the relationships between nutritional status, body composition, and mobility one to 3 years after stroke.
  
  
  METHODS
  Among 279 eligible home-dwelling individuals who had suffered a stroke (except for subarachnoid bleeding) 1-3 years earlier, 134 (74 ± 5 years, 69% men) were examined according to the Mini Nutritional Assessment-Short Form (MNA-SF, 0-14 points), including body mass index (BMI, kg/m(2)), body composition by bio-impedance analyses (Tanita BC-545), the Short Physical Performance Battery (SPPB, 0-12 points) combining walking speed, balance, and chair stand capacity, and the self-reported Physical Activity Scale for the Elderly (PASE).
  
  
  RESULTS
  BMI ≥ 30 kg/m(2) was observed in 22% of cases, and 14% were at risk for malnutrition according to the MNA-SF. SPPB scores ≤ 8 in 28% of cases indicated high risk for disability. Mobility based on the SPPB was not associated with the fat-free mass index (FFMI) or fat mass index (FMI). Multivariate logistic regression indicated that low mobility, i.e., SPPB ≤ 8 points, was independently related to risk for malnutrition (OR 4.3, CI 1.7-10.5, P = 0.02), low physical activity (PASE) (OR 6.5, CI 2.0-21.2, P = 0.02), and high age (OR 0.36, CI 0.15-0.85, P = 0.02). Sarcopenia, defined as a reduced FFMI combined with SPPB scores ≤ 8 or reduced gait speed (<1 m/s), was observed in 7% of cases. None of the individuals displayed sarcopenic obesity (SO), defined as sarcopenia with BMI > 30 kg/m(2).
  
  
  CONCLUSIONS
  Nutritional disorders, i.e., obesity, sarcopenia, or risk for malnutrition, were observed in about one-third of individuals 1 year after stroke. Risk for malnutrition, self-reported physical activity, and age were related to mobility (SPPB), whereas fat-free mass (FFM) and fat mass (FM) were not. Nutrition and exercise treatment could be further evaluated as rehabilitation opportunities after stroke.
authors.affiliation: Physiotherapy, Department of Neuroscience, Uppsala University, Uppsala, Sweden. birgit.vahlberg@neuro.uu.se.
authors.forename: Birgit
authors.initials: B
authors.lastname: Vahlberg
authors.affiliation: Physiotherapy, Department of Neuroscience, Uppsala University, Uppsala, Sweden. lena.zetterberg@neuro.uu.se.
authors.forename: Lena
authors.initials: L
authors.lastname: Zetterberg
authors.affiliation: Physiotherapy, Department of Neuroscience, Uppsala University, Uppsala, Sweden. birgitta.lindmark@neuro.uu.se.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Lindmark
authors.affiliation: Physiotherapy, Department of Neuroscience, Uppsala University, Uppsala, Sweden. karin.hellstrom@neuro.uu.se.
authors.forename: Karin
authors.initials: K
authors.lastname: Hellström
authors.affiliation: Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. tommy.cederholm@pubcare.uu.se.
authors.forename: Tommy
authors.initials: T
authors.lastname: Cederholm
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D057187:Independent Living / Q000639:trends*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology*; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D011597:Psychomotor Performance / Q000502:physiology*; D055948:Sarcopenia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology