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SUN-PP116: Sarcopenia with Disability: Prevalence and Clinical Correlates in Elderly Rehabilitation Patients
S66
Poster presentations
SUN-PP115 LOSS OF FAT-FREE MASS INDEX HAS SUBSTANTIAL IMPACT ON MORTALITY RISK FOR SUBJECTS > 65 YEARS C. Graf1 , V.L. Karsegard2 , A. Spoerri3 , A.-M. Makhlouf2 , S. Ho2 , F. Herrmann1 , G. Laurence2 . 1 Internal Medicine, Rehabilitation and Geriatrics, 2 Clinical Nutrition, University Hospital of Geneva, Geneva, 3 Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland Rationale: A low fat-free mass index (FFMI) predicts mortality in older men but not in older women while fat mass index (FMI) has no impact on mortality. This study aims at determining the relationship between weight and body composition changes and mortality in older subjects. Methods: We included all adults aged >65 yrs who had at least two body composition measurements by bioimpedance analysis (BIA) between 1990 and 2011, at the Geneva University Hospital, as in- or outpatients. Mortality was retrieved from the Geneva death register and the Swiss National Cohort until December 2011 [1]. Co-morbidities were reported in form of the Cumulative Illness Rating Scale (CIRS). For each subject, we calculated the regression slopes for BMI, FMI and FFMI changes. Positive slopes which were significantly different from 0 (p < 0.05) were categorized as “gain”, negative slopes as “loss” and the other slopes as “maintenance”. The impact of BMI, FMI and FFMI changes were evaluated separately by three cox regressions models adjusted for sex and baseline age and CIRS. Results: We included 793 subjects (318 women, 72.5±6.3 yrs, BMI: 25.0±6.0 kg/m2 , CIRS score: 11.9±7.1), of whom 428 died. Results of the Cox regressions models (all models p < 0.001) are shown in the table. HR (95% CI) BMI changes (kg/m2 /yr) FFMI changes (kg/m2 /yr) FMI changes (kg/m2 /yr) Maintenance 1.00 (reference) Gain 0.95 (0.63, 1.44) Loss 0.98 (0.67, 1.43)
1.00 (reference) 1.24 (0.83, 1.84) 1.75 (1.11, 2.75)
1.00 (reference) 0.97 (0.65, 1.44) 0.80 (0.52, 1.23)
A FFMI loss predicted mortality, while BMI and FMI changes had no impact on mortality. Conclusion: FFMI loss predicts mortality in old people regardless of sex, age or initial co-morbidities. Future studies should evaluate whether prevention of FFMI loss improves survival. References [1] Spoerri A et al, Int J Public Health. 2010; 55(4): 239 242. Disclosure of Interest: None declared
SUN-PP116 SARCOPENIA WITH DISABILITY: PREVALENCE AND CLINICAL CORRELATES IN ELDERLY REHABILITATION PATIENTS Y. Yoshimura1 , T. Bise2 . 1 Rehabilitation Medicine, 2 Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto, Japan Rationale: Data on the prevalence and clinical impacts of sarcopenia among elderly rehabilitation patients with physical disabilities are scarce. The aim of this study is to determine the prevalence of sarcopenia and its impact on physical function, nutritional status, and health status in convalescence rehabilitation settings.
Methods: A cross-sectional study was conducted in hospitalized elderly patients in a convalescence rehabilitation ward in Japan. Sarcopenia was defined, according to the Asian Working Group for Sarcopenia (AWGS), as the presence of both low muscle mass, assessed by Bioelectrical Impedance Analysis (BIA), and low muscle function (hand grip strength). The MiniNutritional Assessment short form was used to assess their nutritional status, and the Functional Independence Measure (FIM) was used to evaluate their activities of daily living. Multivariable logistic regression models were used in order to identify factors associated with sarcopenia. Results: This study involved 321 patients (mean age 84.5±8.4 years; 41.9% men). The prevalence of sarcopenia was 54.1%. One hundred twelve patients (35%) were found to be malnourished and 177 (55%) were at risk of malnutrition. Multivariate analysis showed that motor-FIM, cognitive-FIM, MNA-SF score, serum albumin level, and presence of dysphagia were significantly associated factors for the prevalence of sarcopenia, after adjusting for age and sex (p < 0.05). Conclusion: Sarcopenia and malnutrition are frequent among elderly rehabilitation patients with disabilities. Furthermore, sarcopenia is found to be associated with deterioration in activities of daily living and malnutrition. References Wakabayashi H, Sakuma K. Rehabilitation nutrition for sarcopenia with disability: a combination of both rehabilitation and nutrition care management. J Cachexia Sarcopenia Muscle. 2014 Dec; 5(4): 269 77. Disclosure of Interest: None declared
SUN-PP117 INFLUENCE OF DENTAL OCCLUSION AND NUTRITIONAL STATUS ON ACTIVITIES OF DAILY LIVING IN HOSPITALIZED JAPANESE ELDERLY WITH FEMORAL FRACTURE Y. Sawa1 , M. Nakamura2 , H. Nikawa1 . 1 Oral biology and engineering, Hiroshima University, Hiroshima, 2 Rehabilitation, Kashima Hospital, Matsue, Shimane, Japan Rationale: Malnutrition reduces physical function and the loss of natural teeth occlusion is a risk factor for malnutrition. The purpose of this study was to examine the influence of dental occlusion and nutritional status on Activities of Daily Living (ADL) in patients with femoral fracture. Methods: We examined the 138 patients aged over 65 years and over admitted Kashima Hospital Rehabilitation ward between 2010 April and February 2015. The patients were divided into two groups according to occlusal status. The patients in the retained contact group were those who had retained molar occlusion with natural teeth. The patients in the lost contact group were those who retained molar occlusion with removable partial dentures. Nutritional status was evaluated by body mass index (BMI), albumin, hemoglobin, cholinesterase, Controlling Nutritional Status Score (CONUT score) and Mini Nutritional Assessment Short Form (MNA-SF). ADL was assessed using Functional Independence Measure (FIM). Food type was also examined. Multivariate linear regression analysis was performed to determine which variables were independently associated with ADL. Results: According to dental occlusion, the retained contact group included 36 patients (4 men, 32 women, mean age
Poster presentations
SUN-PP115 LOSS OF FAT-FREE MASS INDEX HAS SUBSTANTIAL IMPACT ON MORTALITY RISK FOR SUBJECTS > 65 YEARS C. Graf1 , V.L. Karsegard2 , A. Spoerri3 , A.-M. Makhlouf2 , S. Ho2 , F. Herrmann1 , G. Laurence2 . 1 Internal Medicine, Rehabilitation and Geriatrics, 2 Clinical Nutrition, University Hospital of Geneva, Geneva, 3 Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland Rationale: A low fat-free mass index (FFMI) predicts mortality in older men but not in older women while fat mass index (FMI) has no impact on mortality. This study aims at determining the relationship between weight and body composition changes and mortality in older subjects. Methods: We included all adults aged >65 yrs who had at least two body composition measurements by bioimpedance analysis (BIA) between 1990 and 2011, at the Geneva University Hospital, as in- or outpatients. Mortality was retrieved from the Geneva death register and the Swiss National Cohort until December 2011 [1]. Co-morbidities were reported in form of the Cumulative Illness Rating Scale (CIRS). For each subject, we calculated the regression slopes for BMI, FMI and FFMI changes. Positive slopes which were significantly different from 0 (p < 0.05) were categorized as “gain”, negative slopes as “loss” and the other slopes as “maintenance”. The impact of BMI, FMI and FFMI changes were evaluated separately by three cox regressions models adjusted for sex and baseline age and CIRS. Results: We included 793 subjects (318 women, 72.5±6.3 yrs, BMI: 25.0±6.0 kg/m2 , CIRS score: 11.9±7.1), of whom 428 died. Results of the Cox regressions models (all models p < 0.001) are shown in the table. HR (95% CI) BMI changes (kg/m2 /yr) FFMI changes (kg/m2 /yr) FMI changes (kg/m2 /yr) Maintenance 1.00 (reference) Gain 0.95 (0.63, 1.44) Loss 0.98 (0.67, 1.43)
1.00 (reference) 1.24 (0.83, 1.84) 1.75 (1.11, 2.75)
1.00 (reference) 0.97 (0.65, 1.44) 0.80 (0.52, 1.23)
A FFMI loss predicted mortality, while BMI and FMI changes had no impact on mortality. Conclusion: FFMI loss predicts mortality in old people regardless of sex, age or initial co-morbidities. Future studies should evaluate whether prevention of FFMI loss improves survival. References [1] Spoerri A et al, Int J Public Health. 2010; 55(4): 239 242. Disclosure of Interest: None declared
SUN-PP116 SARCOPENIA WITH DISABILITY: PREVALENCE AND CLINICAL CORRELATES IN ELDERLY REHABILITATION PATIENTS Y. Yoshimura1 , T. Bise2 . 1 Rehabilitation Medicine, 2 Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto, Japan Rationale: Data on the prevalence and clinical impacts of sarcopenia among elderly rehabilitation patients with physical disabilities are scarce. The aim of this study is to determine the prevalence of sarcopenia and its impact on physical function, nutritional status, and health status in convalescence rehabilitation settings.
Methods: A cross-sectional study was conducted in hospitalized elderly patients in a convalescence rehabilitation ward in Japan. Sarcopenia was defined, according to the Asian Working Group for Sarcopenia (AWGS), as the presence of both low muscle mass, assessed by Bioelectrical Impedance Analysis (BIA), and low muscle function (hand grip strength). The MiniNutritional Assessment short form was used to assess their nutritional status, and the Functional Independence Measure (FIM) was used to evaluate their activities of daily living. Multivariable logistic regression models were used in order to identify factors associated with sarcopenia. Results: This study involved 321 patients (mean age 84.5±8.4 years; 41.9% men). The prevalence of sarcopenia was 54.1%. One hundred twelve patients (35%) were found to be malnourished and 177 (55%) were at risk of malnutrition. Multivariate analysis showed that motor-FIM, cognitive-FIM, MNA-SF score, serum albumin level, and presence of dysphagia were significantly associated factors for the prevalence of sarcopenia, after adjusting for age and sex (p < 0.05). Conclusion: Sarcopenia and malnutrition are frequent among elderly rehabilitation patients with disabilities. Furthermore, sarcopenia is found to be associated with deterioration in activities of daily living and malnutrition. References Wakabayashi H, Sakuma K. Rehabilitation nutrition for sarcopenia with disability: a combination of both rehabilitation and nutrition care management. J Cachexia Sarcopenia Muscle. 2014 Dec; 5(4): 269 77. Disclosure of Interest: None declared
SUN-PP117 INFLUENCE OF DENTAL OCCLUSION AND NUTRITIONAL STATUS ON ACTIVITIES OF DAILY LIVING IN HOSPITALIZED JAPANESE ELDERLY WITH FEMORAL FRACTURE Y. Sawa1 , M. Nakamura2 , H. Nikawa1 . 1 Oral biology and engineering, Hiroshima University, Hiroshima, 2 Rehabilitation, Kashima Hospital, Matsue, Shimane, Japan Rationale: Malnutrition reduces physical function and the loss of natural teeth occlusion is a risk factor for malnutrition. The purpose of this study was to examine the influence of dental occlusion and nutritional status on Activities of Daily Living (ADL) in patients with femoral fracture. Methods: We examined the 138 patients aged over 65 years and over admitted Kashima Hospital Rehabilitation ward between 2010 April and February 2015. The patients were divided into two groups according to occlusal status. The patients in the retained contact group were those who had retained molar occlusion with natural teeth. The patients in the lost contact group were those who retained molar occlusion with removable partial dentures. Nutritional status was evaluated by body mass index (BMI), albumin, hemoglobin, cholinesterase, Controlling Nutritional Status Score (CONUT score) and Mini Nutritional Assessment Short Form (MNA-SF). ADL was assessed using Functional Independence Measure (FIM). Food type was also examined. Multivariate linear regression analysis was performed to determine which variables were independently associated with ADL. Results: According to dental occlusion, the retained contact group included 36 patients (4 men, 32 women, mean age