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Observational Study
. 2022 Oct;58(5):683-692.
doi: 10.23736/S1973-9087.22.07514-1. Epub 2022 Sep 5.

Aging after stroke: how to define post-stroke sarcopenia and what are its risk factors?

Sheng Li  1   2 , Javier Gonzalez-Buonomo  3 , Jaskiran Ghuman  4 , Xinran Huang  5 , Aila Malik  6   7 , Nuray Yozbatiran  6   7 , Elaine Magat  6   7 , Gerard E Francisco  6   7 , Hulin Wu  5 , Walter R Frontera  8   9
Affiliations
Observational Study

Aging after stroke: how to define post-stroke sarcopenia and what are its risk factors?

Sheng Li et al. Eur J Phys Rehabil Med. 2022 Oct.

Abstract

Background: Sarcopenia, generally described as "aging-related loss of skeletal muscle mass and function", can occur secondary to a systemic disease.

Aim: This project aimed to study the prevalence of sarcopenia in chronic ambulatory stroke survivors and its associated risk factors using the two most recent diagnostic criteria.

Design: A cross-sectional observational study.

Setting: A scientific laboratory.

Population: Chronic stroke.

Methods: Twenty-eight ambulatory chronic stroke survivors (12 females; mean age=57.8±11.8 years; time after stroke=76±45 months), hand-grip strength, gait speed, and appendicular skeletal muscle mass (ASM) were measured to define sarcopenia. Risk factors, including motor impairment and spasticity, were identified using regression analysis.

Results: The prevalence of sarcopenia varied between 18% and 25% depending on the diagnostic criteria used. A significant difference was seen in the prevalence of low hand grip strength on the affected side (96%) when compared to the contralateral side (25%). The prevalence of slow gait speed was 86% while low ASM was present in 89% of the subjects. Low ASM was marginally negatively correlated with time since stroke and gait speed, but no correlation was observed with age, motor impairment, or spasticity. ASM loss, bone loss and fat deposition were significantly greater in the affected upper limb than in the affected lower limb. Regression analyses showed that time since stroke was a factor associated with bone and muscle loss in the affected upper limb, spasticity had a protective role for muscle loss in the affected lower limb, and walking had a protective role for bone loss in the lower limb.

Conclusions: The prevalence of sarcopenia in stroke survivors is high and is a multifactorial process that is not age-related. Different risk factors contribute to muscle loss in the upper and lower limbs after stroke.

Clinical rehabilitation impact: Clinicians need to be aware of high prevalence of sarcopenia in chronic stroke survivors. Sarcopenia is more evident in the upper than lower limbs. Clinicians also need to understand potential protective roles of some factors, such as spasticity and walking for the muscles in the lower limb.

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Conflict of interest statement

Conflicts of interest.—The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.

Figures

Figure 1
Figure 1
—Muscle mass (A), bone mineral density (BMD) (B) and percent fat (C) of the affected and unaffected upper (UL) and lower (LL) limbs. Mean and standard errors are shown. *statistical significance.
Figure 2
Figure 2
—Bone loss and muscle loss in the UL and LL and leg. Mean and standard errors are shown. *statistical significance.
See this image and copyright information in PMC

References

    1. Rosenberg IH. Summary comments. Am J Clin Nutr 1989;50:1231–3. 10.1093/ajcn/50.5.1231 - DOI
    1. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. ; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019;48:16–31. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&l... 10.1093/ageing/afy169 - DOI - PMC - PubMed
    1. Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc 2020;21:300–307.e2. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&l... 10.1016/j.jamda.2019.12.012 - DOI - PubMed
    1. Reijnierse EM, Trappenburg MC, Leter MJ, Blauw GJ, Sipilä S, Sillanpää E, et al. The Impact of Different Diagnostic Criteria on the Prevalence of Sarcopenia in Healthy Elderly Participants and Geriatric Outpatients. Gerontology 2015;61:491–6. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&l... 10.1159/000377699 - DOI - PubMed
    1. Mas MF, González J, Frontera WR. Stroke and sarcopenia. Curr Phys Med Rehabil Rep 2020;8:452–60. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&l... 10.1007/s40141-020-00284-2 - DOI - PMC - PubMed

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