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Open AccessArticle

Prognosis and Interplay of Cognitive Impairment and Sarcopenia in Older Adults Discharged from Acute Care Hospitals

1
Geriatric Medicine and Geriatric Emergency Care, Italian National Research Center on Aging (IRCCS INRCA), 60127 Ancona, Italy
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Translational Research Center of Nutrition and Ageing, IRCCS INRCA, 60127 Ancona, Italy
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Department of Cardiology, IRCCS INRCA, 60127 Ancona, Italy
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Posture and Movement Analysis Laboratory, IRCCS INRCA, 60127 Ancona, Italy
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Department of Urology, IRCCS INRCA, 60127 Ancona, Italy
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Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, 11330 Stockholm, Sweden
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Department of Cardiovascular, Metabolic and Aging Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
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Department of Medical Sciences, Section of Internal and Cardiorespiratory Medicine, University of Ferrara, 44121 Ferrara, Italy
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Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, 06156 Perugia, Italy
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Unit of Geriatric Pharmacoepidemiology, IRCCS INRCA, 60127 Ancona, Italy
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Italian National Research Center on Aging, Scientific Direction, IRCCS INRCA, 60127 Ancona, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(10), 1693; https://doi.org/10.3390/jcm8101693
Received: 25 September 2019 / Revised: 11 October 2019 / Accepted: 14 October 2019 / Published: 15 October 2019
(This article belongs to the Section Clinical Neurology)
Sarcopenia and cognitive impairment are associated with an increased risk of negative outcomes, but their prognostic interplay has not been investigated so far. We aimed to investigate the prognostic interaction of sarcopenia and cognitive impairment concerning 12-month mortality among older patients discharged from acute care wards in Italy. Our series consisted of 624 patients (age = 80.1 ± 7.0 years, 56.1% women) enrolled in a prospective observational study. Sarcopenia was defined following the European Working Group on Sarcopenia in Older People (EWGSOP) criteria. Cognitive impairment was defined as age- and education-adjusted Mini-Mental State Examination (MMSE) score < 24 or recorded diagnosis of dementia. The study outcome was all-cause mortality during 12-month follow-up. The combination of sarcopenia and cognitive ability was tested against participants with intact cognitive ability and without sarcopenia. Overall, 159 patients (25.5%) were identified as having sarcopenia, and 323 (51.8%) were cognitively impaired. During the follow-up, 79 patients (12.7%) died. After adjusting for potential confounders, the combination of sarcopenia and cognitive impairment has been found associated with increased mortality (HR = 2.12, 95% CI = 1.05–4.13). Such association was also confirmed after excluding patients with dementia (HR = 2.13, 95% CI = 1.06–4.17), underweight (HR = 2.18, 95% CI = 1.03–3.91), high comorbidity burden (HR = 2.63, 95% CI = 1.09–6.32), and severe disability (HR = 2.88, 95% CI = 1.10–5.73). The co-occurrence of sarcopenia and cognitive impairment may predict 1-year mortality in older patients discharged from acute care hospitals. View Full-Text
Keywords: sarcopenia; cognitive impairment; mortality; hospital; older patients sarcopenia; cognitive impairment; mortality; hospital; older patients
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MDPI and ACS Style

Zengarini, E.; Giacconi, R.; Mancinelli, L.; Riccardi, G.R.; Castellani, D.; Vetrano, D.L.; Onder, G.; Volpato, S.; Ruggiero, C.; Fabbietti, P.; Cherubini, A.; Guarasci, F.; Corsonello, A.; Lattanzio, F. Prognosis and Interplay of Cognitive Impairment and Sarcopenia in Older Adults Discharged from Acute Care Hospitals. J. Clin. Med. 2019, 8, 1693. https://doi.org/10.3390/jcm8101693

AMA Style

Zengarini E, Giacconi R, Mancinelli L, Riccardi GR, Castellani D, Vetrano DL, Onder G, Volpato S, Ruggiero C, Fabbietti P, Cherubini A, Guarasci F, Corsonello A, Lattanzio F. Prognosis and Interplay of Cognitive Impairment and Sarcopenia in Older Adults Discharged from Acute Care Hospitals. Journal of Clinical Medicine. 2019; 8(10):1693. https://doi.org/10.3390/jcm8101693

Chicago/Turabian Style

Zengarini, Elisa; Giacconi, Robertina; Mancinelli, Lucia; Riccardi, Giovanni R.; Castellani, Daniele; Vetrano, Davide L.; Onder, Graziano; Volpato, Stefano; Ruggiero, Carmelinda; Fabbietti, Paolo; Cherubini, Antonio; Guarasci, Francesco; Corsonello, Andrea; Lattanzio, Fabrizia. 2019. "Prognosis and Interplay of Cognitive Impairment and Sarcopenia in Older Adults Discharged from Acute Care Hospitals" J. Clin. Med. 8, no. 10: 1693. https://doi.org/10.3390/jcm8101693

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