Mesut Gümüşsoy1, Volkan Atmış2, Ahmet Yalçın3, Remzi Bahşi4, Seher Yiğit5, Sinan Arı6, Haydar Can Dokuyan7, Melih Gaffar Gözükara8, Kamile Silay9. 1. Ankara University School of Medicine, Gastroenterology Department, Ankara, Turkey. Electronic address: mesutgumussoy1987@hotmail.com. 2. Ankara University School of Medicine, Geriatric Medicine Department, Ankara, Turkey. Electronic address: volkanatmis@hotmail.com. 3. Ankara University School of Medicine, Geriatric Medicine Department, Ankara, Turkey. Electronic address: ahmetemreyalcin@hotmail.com. 4. Samsun Education and Research Hospital, Samsun, Turkey. Electronic address: drremzibahsi@gmail.com. 5. Ankara University School of Medicine, Geriatric Medicine Department, Ankara, Turkey. Electronic address: sehersenn@gmail.com. 6. Ankara University School of Medicine, Geriatric Medicine Department, Ankara, Turkey. Electronic address: sinanari82@hotmail.com. 7. Ankara University School of Medicine, Geriatric Medicine Department, Ankara, Turkey. Electronic address: haydardokuyan@gmail.com. 8. Central Public Health Center, Public Health Department, Amasya, Turkey. Electronic address: melihgozukara@hotmail.com. 9. Yildirim Beyazit University School of Medicine, Geriatric Medicine Department, Ankara, Turkey. Electronic address: ksilay@ybu.edu.tr.
Abstract
PURPOSE: Malnutrition-sarcopenia syndrome (MSS) describes the presence of sarcopenia and malnutrition together. This study aims to evaluate the relationship between MSS and all-cause mortality at two years in hospitalised older Turkish people. METHODS: This is a bi-centered prospective cohort study conducted in older individuals in hospital settings (University hospital and research, research and training hospital). Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Muscle mass was measured by bioelectrical impedance analysis. Malnutrition (MN) was assessed by the Mini Nutritional Assessment. Six study groups were formed according to sarcopenia and MN status; MSS, sarcopenia with malnutrition risk (MNR), sarcopenia, MN, MNR, and normal nutrition. The relationship between MSS and other study groups with mortality was assessed by Cox regression model. Survival curves were estimated using the Kaplan-Meier method. RESULTS: 350 hospitalised older people participated (mean age: 77.2 ± 7.6, 56% female). During the 2-year follow-up, 98 (28%) of the participants died. MSS, sarcopenia, sarcopenia with MNR and MN groups were independently associated with all-cause mortality at two years. MSS group had the highest hazard ratio (HR:19.8). Survival curves of MSS sarcopenia, sarcopenia with MNR, and MN groups were significantly different from MNR and normal nutrition groups. MSS had the worst survival curve. CONCLUSIONS: Hospitalised older people should be evaluated for the presence of both sarcopenia and MN because of increased mortality. Preventive measures are needed for both conditions to decrease adverse health outcomes such as mortality.
PURPOSE: Malnutrition-sarcopenia syndrome (MSS) describes the presence of sarcopenia and malnutrition together. This study aims to evaluate the relationship between MSS and all-cause mortality at two years in hospitalised older Turkish people. METHODS: This is a bi-centered prospective cohort study conducted in older individuals in hospital settings (University hospital and research, research and training hospital). Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Muscle mass was measured by bioelectrical impedance analysis. Malnutrition (MN) was assessed by the Mini Nutritional Assessment. Six study groups were formed according to sarcopenia and MN status; MSS, sarcopenia with malnutrition risk (MNR), sarcopenia, MN, MNR, and normal nutrition. The relationship between MSS and other study groups with mortality was assessed by Cox regression model. Survival curves were estimated using the Kaplan-Meier method. RESULTS: 350 hospitalised older people participated (mean age: 77.2 ± 7.6, 56% female). During the 2-year follow-up, 98 (28%) of the participants died. MSS, sarcopenia, sarcopenia with MNR and MN groups were independently associated with all-cause mortality at two years. MSS group had the highest hazard ratio (HR:19.8). Survival curves of MSS sarcopenia, sarcopenia with MNR, and MN groups were significantly different from MNR and normal nutrition groups. MSS had the worst survival curve. CONCLUSIONS: Hospitalised older people should be evaluated for the presence of both sarcopenia and MN because of increased mortality. Preventive measures are needed for both conditions to decrease adverse health outcomes such as mortality.