The association between delirium and sarcopenia in older adult patients admitted to acute geriatrics units: Results from the GLISTEN multicenter observational study

Francesco Landi, Giuseppe Bellelli, Antonella Zambon, Stefano Volpato, Pasquale Abete, Lara Bianchi, Mario Bo, Antonio Cherubini, Francesco Corica, Mauro Di Bari, Marcello Maggio, Giovanna Maria Manca, Maria Rosaria Rizzo, Andrea Rossi, Gloria Brombo, Beatrice Ortolani, Elisabetta Savino, Elisa Maietti, Alberto Fisichella, Valeria ButtòMauro Zamboni, Cesare Caliari, Elena Ferrari, Francesco Orso, Flavia Sacco, Maria Laura Di Meo, Francesca Pittella, Marco Motta, Francesca Massariello, Sergio Fusco, Roberto Schepisi, Christian Ferro, Lorenzo Marchese, Luca Agosta, Claudia Basile, Carla Coppola, Anna Maria Dalise, Ilaria Fava, Olga Catte, Maura Orru, Paolo Salaris, Giuseppina Dell'Aquila, Barbara Carrieri

Risultato della ricerca: Contributo in rivistaArticolo in rivista

4 Citazioni (Scopus)

Abstract

Background & aims: To date, studies assessing the relationship between sarcopenia and delirium, two of the most common geriatric syndromes, are lacking. We sought to explore this association by investigating the co-occurrence of these two conditions and the independent association between them in a population of hospitalized older adults. Methods: Cross-sectional multicenter analysis of older adults consecutively admitted to 12 acute geriatric units (AGUs). Sarcopenia was assessed upon admission by evaluating the presence of low skeletal mass index (kg/m2), and either low handgrip strength or low walking speed (European Working Group on Sarcopenia in Older People, EWGSOP criteria). Skeletal muscle mass was estimated using bioimpedance analysis. Participants underwent a comprehensive geriatric assessment upon admission; information concerning demographics, cognition (Short Portable Status Mental Questionnaire, SPMSQ) functional (Instrumental Activities of Daily Living, IADL and Basic-Activities of Daily Living, BADL), and health status (Charlson Index and specific diseases) was evaluated. The presence of delirium upon admission was ascertained as an explicit clinical diagnosis recorded by the researcher of each centre on the data form. All association estimates were reported as Prevalence Ratios (PRs) and 95% confidence intervals (CIs), using a Cox hazard proportional regression model with robust variance and constant time. Results: Of the 588 analyzed patients (mean age = 80.9 ± 6.8, 53.2% females), 199 (33.8%) had sarcopenia upon admission to the AGU. According to a multivariable Cox regression, delirium upon admission (PR 1.66, 95% CI: 1.12-2.45), IADL total score (PR 0.93, 95% CI: 0.87-0.98), Body Mass Index values (BMI) ranging from 18.5 to 25.0 (PR 1.70, 95% CI: 1.33-2.18), BMI values >18.5 (PR 2.53, 95% CI: 1.81-3.53), previous stroke (PR 1.51, 95% CI: 1.10-2.07) and chronic heart failure (CHF) (PR 1.31, 95% CI: 1.02-1.68) were significantly and independently associated with sarcopenia upon admission to the AGU. Conclusion: The study, carried out in a population of hospitalized older patients, shows that a diagnosis of delirium upon admission to the AGU was more frequent in those with sarcopenia than in others. Furthermore, the study found that delirium was independently associated with the risk of being sarcopenic upon admission to the AGU. Future studies are needed to confirm this association.
Lingua originaleEnglish
pagine (da-a)1715-1722
Numero di pagine8
RivistaClinical Nutrition
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • Body mass index
  • Critical Care and Intensive Care Medicine
  • Delirium
  • Elderly
  • Hospital
  • IADL
  • Nutrition and Dietetics
  • Sarcopenia

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