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Aim: Calf circumference, which is a known simple indicator of muscle mass, increases during edema. However, the extent to which edema increases calf circumference in older adults is unclear. Methods: This retrospective cross‐sectional study included patients aged ≥65 years whose nutritional status was assessed by nutrition support teams. Two different types of matching models in each sex were created according to the presence of edema on the right lower limb. All models were adjusted by age, body height, handgrip strength and performance status. Sarcopenia was diagnosed based on both reduced calf circumference and decline of handgrip strength. The prevalence of sarcopenia was estimated before and after adjustment for increment of calf circumference. Results: In total, 2101 patients were included. Multifactor matching models showed that the mean difference in calf circumference between pairs was 1.6 cm (95% confidence interval [CI] 1.1–2.1, P < 0.001) for women and 2.1 cm (95% CI 1.6–2.7, P < 0.001) for men. The propensity score matching model similarly showed a mean difference of 1.6 cm (95% CI 1.1–2.1, P < 0.001) for women and 2.0 cm (95% CI 1.5–2.6, P < 0.001) for men. The prevalence of sarcopenia before and after adjusting for an edema‐related increase in calf circumference was 42.6%/48.6% for women and 35.3%/38.5%–38.7% for men. Conclusions: Edema in the lower limb increased the calf circumference by approximately 2 cm. When using calf circumference to assess muscle mass in patients with edema, the increase in circumference should be subtracted from the baseline circumference for an accurate assessment. Geriatr Gerontol Int 2019; 19: 993–998. [ABSTRACT FROM AUTHOR]

Aim: Older adults often present with several comorbidities, including sarcopenia. However, the prevalence of sarcopenia and its associations with other comorbidities in hospitalized older adults are unknown. The present study aimed to determine the prevalence of sarcopenia, and its associations with other comorbidities in hospitalized older adults. Methods: The present cross-sectional study included 619 patients admitted to a geriatric hospital. The prevalence of comorbidities in the presence and absence of sarcopenia, nutritional status (according to body mass index and the Mini-Nutritional Assessment-Short Form), and activities of daily living (according to the Barthel Index) were assessed. Sarcopenia was defined as skeletal muscle loss evaluated by both bioelectrical impedance and handgrip strength analyses. Results: Of the 619 participants (mean age 83.0 ± 8.2 years), 417 (67.4%) and 87 (14.1%) had definitive and possible sarcopenia, respectively. The prevalence rates of cognitive impairment and stroke were significantly higher in patients with definitive sarcopenia and those with possible sarcopenia than in those without sarcopenia (cognitive impairment 54.4%, 70.1% and 20.9%, respectively, P < 0.001; stroke 31.2%, 48.3% and 19.1%, respectively, P < 0.001). Multivariate logistic regression analysis showed that cognitive impairment was independently associated with sarcopenia after adjusting for age, sex, the Mini-Nutritional Assessment-Short Form score, Barthel Index and primary disease (adjusted odds ratio 1.98, 95% confidence interval 1.06–3.71; P = 0.032). Conclusions: Sarcopenia might be highly prevalent among hospitalized older adults. Furthermore, cognitive impairment might be an independent explanatory variable of sarcopenia. Therefore, further studies on sarcopenia in patients with cognitive impairment are warranted. [ABSTRACT FROM AUTHOR]

Objectives To investigate the association between loss of muscle mass and aspiration pneumonia ( AP). Design Prospective observational cohort. Setting Acute geriatric hospital. Participants Individuals admitted to the hospital for AP (N = 151; mean age 85.9; 49.7% male). Measurements Appendicular skeletal muscle index ( ASMI; appendicular skeletal muscle mass divided by height squared) was used to evaluate muscle mass. Data on age, sex, body mass index, Mini Nutritional Assessment-Short Form score, Barthel Index score, Charlson Comorbidity Index score, and pneumonia severity (Japanese version of the CURB-65 (C (confusion), U (blood urea nitrogen ≥20 mg/ dL), R (respiratory rate ≥30 breaths/min), B (systolic blood pressure <90 mmHg or diastolic blood pressure ≤60 mmHg), 65 (aged ≥65) severity score (A- DROP)) were obtained. Outcomes included 30- and 90-day mortality. Results Mild, moderate, severe, and extremely severe AP were observed in 1.3%, 70.2%, 25.8%, and 2.6% of participants, respectively. On Kaplan-Meier analysis, participants in the lowest ASMI quartile for each sex were more likely to die than those in the other quartiles (log-lank test P = .005). Multivariate logistic analyses showed that ASMI and A- DROP were independent predictors of 90-day mortality; only A- DROP was a significant predictor of 30-day mortality ( P < .001). Cox regression analysis also showed that the first ASMI quartile was independently associated with mortality (hazard ratio = 2.19; 95% confidence interval = 1.06-4.52; P = .03). Conclusion Low muscle mass is a potential predictor of long-term mortality in individuals with AP. Prospectively preventing muscle mass deterioration may be beneficial for recovery from AP in older adults. [ABSTRACT FROM AUTHOR]

• We investigated the prevalence of postoperative dysphagia in older orthopedic patients. • The prevalence of dysphagia after orthopedic surgery was 16–32 %. • Factors related to postoperative dysphagia included being older, and sarcopenia. • Non-neurogenic dysphagia present in orthopedic patients, and sarcopenia may contribute. Oropharyngeal dysphagia is one of the most prevalent health complications in older adults. The prevalence of postoperative dysphagia is expected to rise with the increasing number of older patients undergoing orthopedic surgery; however, the specific prevalence and contributing factors remain unclear. This scoping review aimed to identify the prevalence and factors related to postoperative dysphagia in older orthopedic patients. This review included studies published up to September 2022 on postoperative patients aged ≥ 60 years who underwent orthopedic surgery. We searched MEDLINE, EMBASE, CINAHL, CENTRAL, Web of Science, and Ichushi-Web. In total, 21 of the 2158 identified studies were reviewed. The studies were classified into the three categories according to the surgical site: cervical spine disease (n = 12), hip fracture (n = 7), and others (n = 2). The estimated dysphagia prevalence rates [95 % confidence interval] of cervical spine disease, hip fractures, and others were 16 % [8–27], 32 % [15–54], and 6 % [4–8], respectively. Factors related to postoperative dysphagia included cervical alignment in cervical spine disease, being older within the cohort, preoperative health status, malnutrition, and sarcopenia in hip fractures. The prevalence of postoperative dysphagia after orthopedic surgery was highest for hip fractures, followed by cervical spine and others. These results suggest non-neurogenic dysphagia in older patients undergoing orthopedic surgery and indicate that sarcopenia may contribute to postoperative dysphagia in this population. Therefore, further research should clarify the trajectory of postoperative dysphagia and the effectiveness of rehabilitation for postoperative dysphagia after orthopedic surgery. [ABSTRACT FROM AUTHOR]