Sarcopenia in post-acute care and rehabilitation of older adults: A review

BackgroundSarcopenia could be involved in post-acute disease and the rehabilitation process, although its prevalence, assessment, diagnostic criteria and treatment in those care settings remains unclear.ObjectiveTo review the literature about sarcopenia in older adults during post-acute care and rehabilitation.MethodsMedline and PEDro searches identified observational and intervention studies published between 2005 and 2015. Researchers independently applied pre-set inclusion criteria and reached consensus on included articles. We recorded study design, setting, population, outcomes, diagnostic criteria, prevalence, the role of sarcopenia (predictor, intervention target intervention, etc), and measurement methods for muscle mass, strength and performance.ResultsWe included 16 studies (9 prospective cohorts, 4 cross-sectional, 1 randomized controlled trial, 1 protocol of a randomized controlled trial and 1 review); mean population ages ranged from 61.5 to 84.6 years). Most frequent settings were rehabilitation wards (9 studies). Most frequent target population was orthopaedic patients (10 studies); no studies specifically addressed stroke, which is highly prevalent in older adults. Nine studies focused on the sarcopenia diagnosis and 7 on sarcopenia as a risk factor for other diseases. Most used assessment tools were bioelectrical impedance analysis for muscle mass, handgrip for muscle strength and gait speed for physical performance. Most studies used EWGSOP criteria. Sarcopenia prevalence was around 50% in hospital-based rehabilitation.ConclusionsThe available evidence about sarcopenia assessment in post-acute care and rehabilitation is scanty, and many aspects remain unclear. This review summarizes the findings from the main studies on this topic, suggesting clinical lessons learned and lines of future research.