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Background/objectives: Texture-modified diets (TMDs) may affect nutritional status and sarcopenia in patients after stroke. This study aimed to investigate the association of food texture levels consumed by patients after stroke with the prevalence of malnutrition and sarcopenia.Subjects/methods: This was a two-center cross-sectional study. A total of 443 patients aged ≥65 years undergoing post-stroke rehabilitation and with oral intake in rehabilitation wards in Shizuoka prefecture and Okinawa prefecture, Japan, were included in the analysis. Food textures were categorized according to the International Dysphagia Diet Standardization Initiative (IDDSI) framework. Malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition and sarcopenia was assess by the European Working Group on Sarcopenia in Older People 2 criteria. The Cochran-Armitage trend test was used to examine the prevalence of malnutrition and sarcopenia by consumption of lower food texture levels.Results: Malnutrition and sarcopenia were diagnosed in 245 (55.3%) and 275 (62.1%) participants, respectively. Consumption of lower food texture levels was associated with a higher prevalence of malnutrition and severe malnutrition (P < 0.001 for both). In addition, consumption of lower food texture levels was associated with a higher prevalence of probable sarcopenia and sarcopenia (P < 0.001 for both). On multivariate analysis, significant associations were observed between IDDSI levels 5 (P < 0.001) and 4 (P = 0.009) and malnutrition, and between IDDSI levels 6 (P = 0.015), 5 (P = 0.033), and 4 (P = 0.015) and sarcopenia.Conclusions: In patients with stroke, consumption of lower food texture levels categorized by the IDDSI framework was associated with a higher prevalence of malnutrition and sarcopenia. [ABSTRACT FROM AUTHOR]

Aim: There is no consensus on energy intake in the acute stage and how it relates to improvement in activities of daily living (ADL) in geriatric stroke patients. We examined whether energy intake after admission is related to improvement in ADL and complications. Methods: This retrospective cohort study evaluated the data from stroke inpatients at five acute care hospitals, including the mean daily energy intake during the first week after admission. Patients were categorized into two groups based on their daily energy intake; cases where the energy intake per day reached the basal energy expenditure calculated by the Harris–Benedict equation were designated as the intake energy sufficiency group. Patient characteristics were compared between groups. We assessed ADL using the Functional Independence Measure; a secondary outcome was the presence of complications. Results: Of the 192 participants (mean age 79.6 ± 7.6 years) included in the study, 131 patients were admitted for cerebral infarction, 58 for intracerebral hemorrhage and three for subarachnoid hemorrhage. Of the two groups, that with an energy sufficiency had a greater gain in total Functional Independence Measure (median 27 and 9, respectively; P = 0.001) and a lower complication rate (6.7% and 26.5%, respectively; P ≤ 0.001). Multivariate analyses showed that energy sufficiency was independently associated with the total Functional Independence Measure gain and complication rate. Conclusions: Energy intake during the first week after admission affected improvement of ADL and onset of complications during hospitalization in geriatric stroke inpatients. Geriatr Gerontol Int 2018; 18: 1334–1339. [ABSTRACT FROM AUTHOR]

In many cases, swallowing function is impaired after the onset of stroke and gradually improves. However, delayed dysphagia has been reported in some post-stroke patients. Recently, several studies have reported that low muscle strength and decreased muscle mass cause dysphagia. This study aimed to investigate whether these conditions are associated with delayed dysphagia after stroke. A multicenter prospective observational cohort study. Participants included 165 patients with post-stroke dysphagia (mean age 79.1 ± 8.0 years, 53.3% women) admitted to rehabilitation wards for post-stroke rehabilitation. Swallowing function was assessed using the Functional Oral Intake Scale. Delayed dysphagia was defined as dysphagia that occurred more than 7 days after stroke onset. We used logistic regression to examine the independent association between low muscle strength and decreased muscle mass and delayed dysphagia development. Furthermore, we examined the relationship between improvement in dysphagia and delayed dysphagia. Delayed dysphagia was observed in 18 (10.9%) patients. The combination of severely low muscle strength and decreased muscle mass was independently associated with the development of delayed dysphagia (adjusted odds ratio: 4.423, 95% confidence interval: 1.400–13.974, P =.011). Delayed dysphagia had an adverse effect on the improvement of dysphagia during in-hospital rehabilitation (adjusted odds ratio: 0.278, 95% confidence interval: 0.078–0.986, P =.047). The development of delayed dysphagia was influenced by a combination of severely low muscle strength and decreased muscle mass. Furthermore, delayed dysphagia adversely affects the improvement of dysphagia in patients with stroke and needs to be identified early. Identifying delayed dysphagia using the methods proposed in this study and incorporating early intervention may prevent or delay dependency conditions in this population. [ABSTRACT FROM AUTHOR]