Geriatrics & Gerontology International · Aug 1, 2017
Prognostic value of physical function tests and muscle mass in elderly hospitalized patients. A prospective observational study
By Hernández-Luis R, Martín-Ponce E, Monereo-Muñoz M et al.
AIM: To determine the prognostic value for mortality of physical function tests, muscle mass loss, disability and frailty in elderly hospitalized patients. METHODS: We prospectively included 298 hospitalized patients aged >60 years (152 men and 146 women). We assessed comorbidity using the Charlson Comorbidity Index; nutrition by body mass index, midarm muscle area and subjective nutritional score; physical muscle function by handgrip strength, gait speed, standing balance and stand up test; disability using the Barthel test and activities of daily living; frailty by the clinical frailty scale and Fried frailty index; and cognitive impairment by the Pfeiffer test. We assessed 100-day and long-term mortality. RESULTS: We found a high prevalence of malnutrition, comorbidity, cognitive impairment, physical function impairment, disability and frailty. Mortality at 100 days was 15.1%, with a long-term median survival of 989 days. Mortality was significantly related to age, comorbidity, nutritional status, physical function, disability and frailty. Serum vitamin D₃ levels were not related to mortality. Independent prognostic value for long-term mortality was shown by: (i) incapacity to carry out any of the walking, stand up and standing balance tests; (ii) male sex; (iii) aged >80 years; (iv) impaired handgrip strength or gait speed; (v) Charlson Comorbidity Index ≥1; and (6) impaired muscle mass of subjective nutritional score. CONCLUSIONS: In elderly hospitalized patients, there is an important role of muscle regarding prognosis, mainly related to physical function, but also and independently regarding muscle mass. Geriatr Gerontol Int 2018; 18: 57-64.