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JFSF Vol 7, No 3, September 2022, p.103-116

doi: 10.22540/JFSF-07-103

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Original Article

Induced frailty and acute sarcopenia are overlapping consequences of hospitalisation in older adults

Carly Welch1,2,3, Carolyn Greig1,4,5, Zeinab Majid2,3, Tahir Masud1,6,7, Hannah Moorey2,3, Thomas Pinkney3,8, Thomas Jackson1,2,3

  1. Medical Research Council (MRC) – Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, UK
  2. Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
  3. University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  4. School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
  5. Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  6. Nottingham University Hospitals NHS Trust, Nottingham, UK
  7. University of Nottingham, Nottingham, UK
  8. Academic Department of Surgery, University of Birmingham, Birmingham, UK

Keywords: Acute sarcopenia, Frailty, Induced frailty, Sarcopenia

Abstract

Objectives: To determine the effects of hospitalisation upon frailty and sarcopenia. Methods: Prospective cohort study at single UK hospital including adults ≥70 years-old admitted for elective colorectal surgery, emergency abdominal surgery, or acute infections. Serial assessments for frailty (Fried, Frailty Index, Clinical Frailty Scale [CFS]), and sarcopenia (handgrip strength, ultrasound quadriceps and/or bioelectrical impedance analysis, and gait speed and/or Short Physical Performance Battery) were conducted at baseline, 7 days post-admission/post-operatively, and 13 weeks post-admission/post-operatively. Results: Eighty participants were included (mean age 79.2, 38.8% females). Frailty prevalence by all criteria at baseline was higher among medical compared to surgical participants. Median and estimated marginal CFS values and Fried frailty prevalence increased after 7 days, with rates returning towards baseline at 13 weeks. Sarcopenia incidence amongst those who did not have sarcopenia at baseline was 20.0%. However, some participants demonstrated improvements in sarcopenia status, and overall sarcopenia prevalence did not change. There was significant overlap between diagnoses with 37.3% meeting criteria for all four diagnoses at 7 days. Conclusions: Induced frailty and acute sarcopenia are overlapping conditions affecting older adults during hospitalisation. Rates of frailty returned towards baseline at 13 weeks, suggesting that induced frailty is reversible.
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