title: Low skeletal muscle mass index is associated with function and nutritional status in residents in a Turkish nursing home.
abstract: BACKGROUND
  To determine the prevalence of low muscle mass (LMM) and the relationship between LMM with functional and nutritional status as defined using the LMM evaluation method of European Working Group on Sarcopenia in Older People (EWGSOP) criteria among male residents in a nursing home.
  
  
  METHODS
  Male residents aged >60 years of a nursing home located in Turkey were included in our study. Their body mass index (BMI) kg/m2, skeletal muscle mass (SMM-kg) and skeletal muscle mass index (SMMI-kg/m2) were calculated. The participants were regarded as having low SMMI if they had SMMI <9.2 kg/m2according to our population specific cut-off point. Functional status was evaluated with Katz activities of daily living (ADL) and Lawton Instrumental Activities of Daily Living (IADL). Nutritional assessment was performed using the Mini Nutritional Assessment (MNA). The number of drugs taken and chronic diseases were recorded.
  
  
  RESULTS
  One hundred fifty-seven male residents were enrolled into the study. Their mean age was 73.1 ± 6.7 years with mean ADL score of 8.9 ± 2.0 and IADL score of 8.7 ± 4.6. One hundred twelve (71%) residents were aged >70 years. Thirty-five men (23%) had low SMMI in group aged >60 years, and twenty-eight subjects (25%) in the group aged >70 years. MNA scores were significantly lower in residents with low SMMI compared with having normal SMMI (17.1 ± 3.4 versus 19.6 ± 2.5, p = 0.005). BMI was significantly lower in the residents with low SMMI compared with normal SMMI (19.6 ± 2.7 versus 27.1 ± 4.1, p< 0.001). ADL scores were significantly different between residents with low SMMI and normal SMMI in those aged >70 years (8.1 ± 2.6 versus 9.1 ± 1.6, p = 0.014). In regression analyses, the only factor associated with better functional status was the lower age (p = 0.04) while the only factor associated with better nutrition was higher SMMI (p = 0.01).
  
  
  CONCLUSIONS
  Low SMMI detected by LMM evaluation method of EWGSOP criteria is prevalent among male nursing home residents. There is association of low SMMI with nutritional status and probably with functional status within the nursing home setting using the EWGSOP criteria with Turkish normative reference cut-off value.
authors.affiliation: a Department of Internal Medicine , Division of Geriatrics, Marmara University Hospital , Istanbul , Turkey.
authors.forename: Asli
authors.initials: A
authors.lastname: Tufan
authors.affiliation: b Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University , Istanbul , Turkey.
authors.forename: Gulistan
authors.initials: G
authors.lastname: Bahat
authors.affiliation: c Department of Health and Social Services , Kayışdagi Darulaceze Ministry, Istanbul Metropolitan Municipality , Istanbul , Turkey , and.
authors.forename: Hilal
authors.initials: H
authors.lastname: Ozkaya
authors.affiliation: b Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University , Istanbul , Turkey.
authors.forename: Didem
authors.initials: D
authors.lastname: Taşcıoğlu
authors.affiliation: b Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University , Istanbul , Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Tufan
authors.affiliation: b Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University , Istanbul , Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Saka
authors.affiliation: d Department of Internal Medicine , Division of Geriatrics, Erciyes University Hospital , Kayseri , Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Akin
authors.affiliation: b Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University , Istanbul , Turkey.
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Karan
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D015596:Nutrition Assessment; D009752:Nutritional Status; D055948:Sarcopenia / Q000453:epidemiology* / Q000209:etiology; D014421:Turkey / Q000453:epidemiology
keywords: EWGSOP; low skeletal muscle mass; male; nursing home; nutritional status