Skip to main content
Top
Published in: BMC Geriatrics 1/2018

Open Access 01-12-2018 | Research article

Sarcopenia as a predictor of hospitalization among older people: a systematic review and meta-analysis

Authors: Xiaoming Zhang, Wenwu Zhang, Conghua Wang, Wuyuan Tao, Qingli Dou, Yunzhi Yang

Published in: BMC Geriatrics | Issue 1/2018

Login to get access

Abstract

Background

Previous cohort studies investigating the association between sarcopenia and the risk of hospitalization have been inconsistent. We performed a meta-analysis to determine if sarcopenia is a predictor of hospitalization.

Methods

Prospective cohort studies that evaluated the association between sarcopenia and hospitalization in older people were identified via a systematic search of four electronic databases (PubMed, EMBASE, Science Citation Index, and the Cochrane Library). A random-effect model was applied to combine the results according to the heterogeneity of the included studies.

Results

Five studies (2832 participants) were included in this meta-analysis. Pooled results demonstrated that older people with sarcopenia were at an increased risk of hospitalization (pooled hazards ratio [HR] = 1.57, 95% confidence interval [CI] = 1.26, 1.94, I2 = 4.5%, P = 0.000) compared to those without sarcopenia. Results of subgroup analyses showed that hospitalized patients with sarcopenia had a higher rate of hospitalization (HR = 2.01, 95% CI = 1.41, 2.88, p = 0.000) versus patients without sarcopenia. A similar result was also found in community-dwelling older people with sarcopenia versus those without sarcopenia (HR = 1.40, 95% CI = 1.05, 1.88, p = 0.023). In addition, the subgroup analysis for length of follow-up showed that studies with a follow-up period of 3 years or more (pooled HR = 1.52, 95% CI = 1.19, 1.94, P = 0.001) reported a significantly higher rate of hospitalization among individuals with sarcopenia compared to those without sarcopenia. However, this association was not found in the studies with a follow-up period of less than 3 years (pooled HR = 1.76, 95% CI = 0.90, 3.44, P = 0.099).

Conclusions

Sarcopenia is a significant predictor of hospitalization among older individuals, and the association may not be significantly affected by the characteristics of the population or the definition of sarcopenia.
Appendix
Available only for authorised users
Literature
1.
2.
go back to reference Marzetti E, Calvani R, Tosato M, Cesari M, Di Bari M, Cherubini A, Collamati A, D'Angelo E, Pahor M, Bernabei R, et al. Sarcopenia: an overview. Aging Clin Exp Res. 2017;29(1):11–7.CrossRefPubMed Marzetti E, Calvani R, Tosato M, Cesari M, Di Bari M, Cherubini A, Collamati A, D'Angelo E, Pahor M, Bernabei R, et al. Sarcopenia: an overview. Aging Clin Exp Res. 2017;29(1):11–7.CrossRefPubMed
3.
go back to reference Cruz-Jentoft AJ, Landi F, Schneider SM, Zuniga C, Arai H, Boirie Y, Chen LK, Fielding RA, Martin FC, Michel JP, et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the international sarcopenia initiative (EWGSOP and IWGS). Age Ageing. 2014;43(6):748–59.CrossRefPubMedPubMedCentral Cruz-Jentoft AJ, Landi F, Schneider SM, Zuniga C, Arai H, Boirie Y, Chen LK, Fielding RA, Martin FC, Michel JP, et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the international sarcopenia initiative (EWGSOP and IWGS). Age Ageing. 2014;43(6):748–59.CrossRefPubMedPubMedCentral
4.
go back to reference Cruz-Jentoft AJ, Landi F, Topinkova E, Michel JP. Understanding sarcopenia as a geriatric syndrome. Curr Opin Clin Nutr Metab Care. 2010;13(1):1–7.CrossRefPubMed Cruz-Jentoft AJ, Landi F, Topinkova E, Michel JP. Understanding sarcopenia as a geriatric syndrome. Curr Opin Clin Nutr Metab Care. 2010;13(1):1–7.CrossRefPubMed
5.
go back to reference Marty E, Liu Y, Samuel A, Or O, Lane J. A review of sarcopenia: enhancing awareness of an increasingly prevalent disease. Bone. 2017;105:276–86.CrossRefPubMed Marty E, Liu Y, Samuel A, Or O, Lane J. A review of sarcopenia: enhancing awareness of an increasingly prevalent disease. Bone. 2017;105:276–86.CrossRefPubMed
6.
go back to reference Landi F, Liperoti R, Russo A, Giovannini S, Tosato M, Capoluongo E, Bernabei R, Onder G. Sarcopenia as a risk factor for falls in elderly individuals: results from the ilSIRENTE study. Clin Nutr (Edinburgh, Scotland). 2012;31(5):652–8.CrossRef Landi F, Liperoti R, Russo A, Giovannini S, Tosato M, Capoluongo E, Bernabei R, Onder G. Sarcopenia as a risk factor for falls in elderly individuals: results from the ilSIRENTE study. Clin Nutr (Edinburgh, Scotland). 2012;31(5):652–8.CrossRef
7.
go back to reference Yu R, Leung J, Woo J. Incremental predictive value of sarcopenia for incident fracture in an elderly Chinese cohort: results from the osteoporotic fractures in men (MrOs) study. J Am Med Dir Assoc. 2014;15(8):551–8.CrossRefPubMed Yu R, Leung J, Woo J. Incremental predictive value of sarcopenia for incident fracture in an elderly Chinese cohort: results from the osteoporotic fractures in men (MrOs) study. J Am Med Dir Assoc. 2014;15(8):551–8.CrossRefPubMed
8.
go back to reference Gale CR, Martyn CN, Cooper C, Sayer AA. Grip strength, body composition, and mortality. Int J Epidemiol. 2007;36(1):228–35.CrossRefPubMed Gale CR, Martyn CN, Cooper C, Sayer AA. Grip strength, body composition, and mortality. Int J Epidemiol. 2007;36(1):228–35.CrossRefPubMed
9.
go back to reference Chang KV, Hsu TH, Wu WT, Huang KC, Han DS. Is sarcopenia associated with depression? A systematic review and meta-analysis of observational studies. Age Ageing. 2017;46(5):738–46.CrossRefPubMed Chang KV, Hsu TH, Wu WT, Huang KC, Han DS. Is sarcopenia associated with depression? A systematic review and meta-analysis of observational studies. Age Ageing. 2017;46(5):738–46.CrossRefPubMed
11.
go back to reference Wang SY, Shamliyan TA, Talley KM, Ramakrishnan R, Kane RL. Not just specific diseases: systematic review of the association of geriatric syndromes with hospitalization or nursing home admission. Arch Gerontol Geriatr. 2013;57(1):16–26.CrossRefPubMed Wang SY, Shamliyan TA, Talley KM, Ramakrishnan R, Kane RL. Not just specific diseases: systematic review of the association of geriatric syndromes with hospitalization or nursing home admission. Arch Gerontol Geriatr. 2013;57(1):16–26.CrossRefPubMed
12.
go back to reference Liu P, Hao Q, Hai S, Wang H, Cao L, Dong B. Sarcopenia as a predictor of all-cause mortality among community-dwelling older people: a systematic review and meta-analysis. Maturitas. 2017;103:16–22.CrossRefPubMed Liu P, Hao Q, Hai S, Wang H, Cao L, Dong B. Sarcopenia as a predictor of all-cause mortality among community-dwelling older people: a systematic review and meta-analysis. Maturitas. 2017;103:16–22.CrossRefPubMed
13.
go back to reference Cawthon PM, Fox KM, Gandra SR, Delmonico MJ, Chiou CF, Anthony MS, Sewall A, Goodpaster B, Satterfield S, Cummings SR, et al. Do muscle mass, muscle density, strength, and physical function similarly influence risk of hospitalization in older adults? J Am Geriatr Soc. 2009;57(8):1411–9.CrossRefPubMedPubMedCentral Cawthon PM, Fox KM, Gandra SR, Delmonico MJ, Chiou CF, Anthony MS, Sewall A, Goodpaster B, Satterfield S, Cummings SR, et al. Do muscle mass, muscle density, strength, and physical function similarly influence risk of hospitalization in older adults? J Am Geriatr Soc. 2009;57(8):1411–9.CrossRefPubMedPubMedCentral
14.
go back to reference Bianchi L, Ferrucci L, Cherubini A, Maggio M, Bandinelli S, Savino E, Brombo G, Zuliani G, Guralnik JM, Landi F, et al. The predictive value of the EWGSOP definition of sarcopenia: results from the InCHIANTI study. J Gerontol A Biol Sci Med Sci. 2016;71(2):259–64.CrossRefPubMed Bianchi L, Ferrucci L, Cherubini A, Maggio M, Bandinelli S, Savino E, Brombo G, Zuliani G, Guralnik JM, Landi F, et al. The predictive value of the EWGSOP definition of sarcopenia: results from the InCHIANTI study. J Gerontol A Biol Sci Med Sci. 2016;71(2):259–64.CrossRefPubMed
15.
go back to reference Yang M, Hu X, Wang H, Zhang L, Hao Q, Dong B. Sarcopenia predicts readmission and mortality in elderly patients in acute care wards: a prospective study. J Cachexia Sarcopenia Muscle. 2017;8(2):251–8.CrossRefPubMed Yang M, Hu X, Wang H, Zhang L, Hao Q, Dong B. Sarcopenia predicts readmission and mortality in elderly patients in acute care wards: a prospective study. J Cachexia Sarcopenia Muscle. 2017;8(2):251–8.CrossRefPubMed
16.
go back to reference Gariballa S, Alessa A. Sarcopenia: prevalence and prognostic significance in hospitalized patients. Clin Nutr. 2013;32(5):772–6.CrossRefPubMed Gariballa S, Alessa A. Sarcopenia: prevalence and prognostic significance in hospitalized patients. Clin Nutr. 2013;32(5):772–6.CrossRefPubMed
17.
go back to reference Cawthon PM, Lui LY, Taylor BC, McCulloch CE, Cauley JA, Lapidus J, Orwoll E, Ensrud KE. Clinical definitions of sarcopenia and risk of hospitalization in community-dwelling older men: the osteoporotic fractures in men study. J Gerontol A Biol Sci Med Sci. 2017;72(10):1383–9.CrossRefPubMedPubMedCentral Cawthon PM, Lui LY, Taylor BC, McCulloch CE, Cauley JA, Lapidus J, Orwoll E, Ensrud KE. Clinical definitions of sarcopenia and risk of hospitalization in community-dwelling older men: the osteoporotic fractures in men study. J Gerontol A Biol Sci Med Sci. 2017;72(10):1383–9.CrossRefPubMedPubMedCentral
18.
go back to reference Henwood T, Hassan B, Swinton P, Senior H, Keogh J. Consequences of sarcopenia among nursing home residents at long-term follow-up. Geriatr Nurs. 2017;38(5):406–11.CrossRefPubMed Henwood T, Hassan B, Swinton P, Senior H, Keogh J. Consequences of sarcopenia among nursing home residents at long-term follow-up. Geriatr Nurs. 2017;38(5):406–11.CrossRefPubMed
19.
go back to reference Beaudart C, Zaaria M, Pasleau F, Reginster JY, Bruyere O. Health outcomes of sarcopenia: a systematic review and meta-analysis. PLoS One. 2017;12(1):e0169548.CrossRefPubMedPubMedCentral Beaudart C, Zaaria M, Pasleau F, Reginster JY, Bruyere O. Health outcomes of sarcopenia: a systematic review and meta-analysis. PLoS One. 2017;12(1):e0169548.CrossRefPubMedPubMedCentral
20.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int. J. Surg. 2010;8(5):336–41.CrossRefPubMed Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int. J. Surg. 2010;8(5):336–41.CrossRefPubMed
21.
go back to reference Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603–5.CrossRefPubMed Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603–5.CrossRefPubMed
22.
go back to reference Lera L, Albala C, Sanchez H, Angel B, Hormazabal MJ, Marquez C, Arroyo P. Prevalence of sarcopenia in community-dwelling Chilean elders according to an adapted version of the European working group on sarcopenia in older people (EWGSOP) criteria. J Frailty Aging. 2017;6(1):12–7.PubMed Lera L, Albala C, Sanchez H, Angel B, Hormazabal MJ, Marquez C, Arroyo P. Prevalence of sarcopenia in community-dwelling Chilean elders according to an adapted version of the European working group on sarcopenia in older people (EWGSOP) criteria. J Frailty Aging. 2017;6(1):12–7.PubMed
23.
go back to reference Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, Chou MY, Chen LY, Hsu PS, Krairit O, et al. Sarcopenia in Asia: consensus report of the Asian working Group for Sarcopenia. J Am Med Dir Assoc. 2014;15(2):95–101.CrossRefPubMed Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, Chou MY, Chen LY, Hsu PS, Krairit O, et al. Sarcopenia in Asia: consensus report of the Asian working Group for Sarcopenia. J Am Med Dir Assoc. 2014;15(2):95–101.CrossRefPubMed
24.
go back to reference Padilla Colon CJ, Sanchez Collado P, Cuevas MJ. Benefits of strength training for the prevention and treatment of sarcopenia. Nutr Hosp. 2014;29(5):979–88.PubMed Padilla Colon CJ, Sanchez Collado P, Cuevas MJ. Benefits of strength training for the prevention and treatment of sarcopenia. Nutr Hosp. 2014;29(5):979–88.PubMed
25.
go back to reference Bano G, Trevisan C, Carraro S, Solmi M, Luchini C, Stubbs B, Manzato E, Sergi G, Veronese N. Inflammation and sarcopenia: a systematic review and meta-analysis. Maturitas. 2017;96:10–5.CrossRefPubMed Bano G, Trevisan C, Carraro S, Solmi M, Luchini C, Stubbs B, Manzato E, Sergi G, Veronese N. Inflammation and sarcopenia: a systematic review and meta-analysis. Maturitas. 2017;96:10–5.CrossRefPubMed
26.
go back to reference Waltz TB, Fivenson EM, Morevati M, Li C, Becker KG, Bohr VA, Fang EF. Sarcopenia, aging and prospective interventional strategies. Curr Med Chem. 2017;24(1):1–8. Waltz TB, Fivenson EM, Morevati M, Li C, Becker KG, Bohr VA, Fang EF. Sarcopenia, aging and prospective interventional strategies. Curr Med Chem. 2017;24(1):1–8.
27.
go back to reference Volpato S, Cavalieri M, Sioulis F, Guerra G, Maraldi C, Zuliani G, Fellin R, Guralnik JM. Predictive value of the short physical performance battery following hospitalization in older patients. J Gerontol A Biol Sci Med Sci. 2011;66(1):89–96. Volpato S, Cavalieri M, Sioulis F, Guerra G, Maraldi C, Zuliani G, Fellin R, Guralnik JM. Predictive value of the short physical performance battery following hospitalization in older patients. J Gerontol A Biol Sci Med Sci. 2011;66(1):89–96.
28.
go back to reference Legrand D, Vaes B, Mathei C, Adriaensen W, Van Pottelbergh G, Degryse JM. Muscle strength and physical performance as predictors of mortality, hospitalization, and disability in the oldest old. J Am Geriatr Soc. 2014;62(6):1030–8.CrossRefPubMed Legrand D, Vaes B, Mathei C, Adriaensen W, Van Pottelbergh G, Degryse JM. Muscle strength and physical performance as predictors of mortality, hospitalization, and disability in the oldest old. J Am Geriatr Soc. 2014;62(6):1030–8.CrossRefPubMed
30.
go back to reference Matsumoto H, Tanimura C: Sarcopenia is a risk factor for falling in independently living Japanese older adults: a 2-year prospective cohort study of the GAINA study. 2017. Matsumoto H, Tanimura C: Sarcopenia is a risk factor for falling in independently living Japanese older adults: a 2-year prospective cohort study of the GAINA study. 2017.
31.
go back to reference Bischoff-Ferrari HA, Orav JE, Kanis JA, Rizzoli R, Schlogl M, Staehelin HB, Willett WC, Dawson-Hughes B. Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community-dwelling seniors age 65 and older. Osteoporos Int. 2015;26(12):2793–802.CrossRefPubMed Bischoff-Ferrari HA, Orav JE, Kanis JA, Rizzoli R, Schlogl M, Staehelin HB, Willett WC, Dawson-Hughes B. Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community-dwelling seniors age 65 and older. Osteoporos Int. 2015;26(12):2793–802.CrossRefPubMed
32.
go back to reference Clynes MA, Edwards MH, Buehring B, Dennison EM, Binkley N, Cooper C. Definitions of sarcopenia: associations with previous falls and fracture in a population sample. Calcif Tissue Int. 2015;97(5):445–52.CrossRefPubMedPubMedCentral Clynes MA, Edwards MH, Buehring B, Dennison EM, Binkley N, Cooper C. Definitions of sarcopenia: associations with previous falls and fracture in a population sample. Calcif Tissue Int. 2015;97(5):445–52.CrossRefPubMedPubMedCentral
33.
go back to reference Scott D, Seibel M, Cumming R, Naganathan V, Blyth F, Le Couteur DG, Handelsman DJ, Waite LM, Hirani V. Sarcopenic obesity and its temporal associations with changes in bone mineral density, incident falls, and fractures in older men: the concord health and ageing in men project. J Bone Miner Res Off J Am Soc Bone Miner Res. 2017;32(3):575–83.CrossRef Scott D, Seibel M, Cumming R, Naganathan V, Blyth F, Le Couteur DG, Handelsman DJ, Waite LM, Hirani V. Sarcopenic obesity and its temporal associations with changes in bone mineral density, incident falls, and fractures in older men: the concord health and ageing in men project. J Bone Miner Res Off J Am Soc Bone Miner Res. 2017;32(3):575–83.CrossRef
34.
35.
go back to reference Marzetti E, Lees HA, Wohlgemuth SE, Leeuwenburgh C. Sarcopenia of aging: underlying cellular mechanisms and protection by calorie restriction. BioFactors (Oxford, England). 2009;35(1):28–35.CrossRef Marzetti E, Lees HA, Wohlgemuth SE, Leeuwenburgh C. Sarcopenia of aging: underlying cellular mechanisms and protection by calorie restriction. BioFactors (Oxford, England). 2009;35(1):28–35.CrossRef
36.
go back to reference Cruz-Jentoft AJ, Kiesswetter E, Drey M, Sieber CC. Nutrition, frailty, and sarcopenia. Aging Clin Exp Res. 2017;29(1):43–8.CrossRefPubMed Cruz-Jentoft AJ, Kiesswetter E, Drey M, Sieber CC. Nutrition, frailty, and sarcopenia. Aging Clin Exp Res. 2017;29(1):43–8.CrossRefPubMed
37.
go back to reference Martone AM, Lattanzio F, Abbatecola AM, Carpia DL, Tosato M, Marzetti E, Calvani R, Onder G, Landi F. Treating sarcopenia in older and oldest old. Curr Pharm Des. 2015;21(13):1715–22.CrossRefPubMed Martone AM, Lattanzio F, Abbatecola AM, Carpia DL, Tosato M, Marzetti E, Calvani R, Onder G, Landi F. Treating sarcopenia in older and oldest old. Curr Pharm Des. 2015;21(13):1715–22.CrossRefPubMed
38.
go back to reference Westbury LD, Fuggle NR, Syddall HE, Duggal NA, Shaw SC, Maslin K, Dennison EM, Lord JM, Cooper C. Relationships between markers of inflammation and muscle mass, Strength and Function: Findings from the Hertfordshire Cohort Study. Calcif Tissue Int. 2018;102(3):2872–95. Westbury LD, Fuggle NR, Syddall HE, Duggal NA, Shaw SC, Maslin K, Dennison EM, Lord JM, Cooper C. Relationships between markers of inflammation and muscle mass, Strength and Function: Findings from the Hertfordshire Cohort Study. Calcif Tissue Int. 2018;102(3):2872–95.
39.
go back to reference Malafarina V, Uriz-Otano F, Iniesta R, Gil-Guerrero L. Sarcopenia in the elderly: diagnosis, physiopathology and treatment. Maturitas. 2012;71(2):109–14. Malafarina V, Uriz-Otano F, Iniesta R, Gil-Guerrero L. Sarcopenia in the elderly: diagnosis, physiopathology and treatment. Maturitas. 2012;71(2):109–14.
40.
go back to reference Hars M, Biver E, Chevalley T, Herrmann F, Rizzoli R, Ferrari S, Trombetti A. Low lean mass predicts incident fractures independently from FRAX: a prospective cohort study of recent retirees. J Bone Miner Res Off J Am Soc Bone Miner Res. 2016;31(11):2048–56.CrossRef Hars M, Biver E, Chevalley T, Herrmann F, Rizzoli R, Ferrari S, Trombetti A. Low lean mass predicts incident fractures independently from FRAX: a prospective cohort study of recent retirees. J Bone Miner Res Off J Am Soc Bone Miner Res. 2016;31(11):2048–56.CrossRef
41.
go back to reference Chalhoub D, Cawthon PM, Ensrud KE, Stefanick ML, Kado DM, Boudreau R, Greenspan S, Newman AB, Zmuda J, Orwoll ES, et al. Risk of nonspine fractures in older adults with sarcopenia, low bone mass, or both. J Am Geriatr Soc. 2015;63(9):1733–40.CrossRefPubMedPubMedCentral Chalhoub D, Cawthon PM, Ensrud KE, Stefanick ML, Kado DM, Boudreau R, Greenspan S, Newman AB, Zmuda J, Orwoll ES, et al. Risk of nonspine fractures in older adults with sarcopenia, low bone mass, or both. J Am Geriatr Soc. 2015;63(9):1733–40.CrossRefPubMedPubMedCentral
42.
go back to reference Scott D, Chandrasekara SD, Laslett LL, Cicuttini F, Ebeling PR, Jones G. Associations of Sarcopenic obesity and Dynapenic obesity with bone mineral density and incident fractures over 5-10 years in community-dwelling older adults. Calcif Tissue Int. 2016;99(1):30–42.CrossRefPubMed Scott D, Chandrasekara SD, Laslett LL, Cicuttini F, Ebeling PR, Jones G. Associations of Sarcopenic obesity and Dynapenic obesity with bone mineral density and incident fractures over 5-10 years in community-dwelling older adults. Calcif Tissue Int. 2016;99(1):30–42.CrossRefPubMed
43.
go back to reference Zembron-Lacny A, Dziubek W, Rogowski L, Skorupka E, Dabrowska G. Sarcopenia: monitoring, molecular mechanisms, and physical intervention. Physiol Res. 2014;63(6):683–91.PubMed Zembron-Lacny A, Dziubek W, Rogowski L, Skorupka E, Dabrowska G. Sarcopenia: monitoring, molecular mechanisms, and physical intervention. Physiol Res. 2014;63(6):683–91.PubMed
44.
go back to reference Bosaeus I, Rothenberg E. Nutrition and physical activity for the prevention and treatment of age-related sarcopenia. Proc Nutr Soc. 2016;75(2):174–80.CrossRefPubMed Bosaeus I, Rothenberg E. Nutrition and physical activity for the prevention and treatment of age-related sarcopenia. Proc Nutr Soc. 2016;75(2):174–80.CrossRefPubMed
Metadata
Title
Sarcopenia as a predictor of hospitalization among older people: a systematic review and meta-analysis
Authors
Xiaoming Zhang
Wenwu Zhang
Conghua Wang
Wuyuan Tao
Qingli Dou
Yunzhi Yang
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2018
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-018-0878-0

Other articles of this Issue 1/2018

BMC Geriatrics 1/2018 Go to the issue