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Malnutrition, Acute Sarcopenia and Wasting Syndromes during Hospital Stay

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Geriatric Nutrition".

Deadline for manuscript submissions: closed (15 November 2024) | Viewed by 6210

Special Issue Editor


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Guest Editor
Unit of General Medicine and Advanced Care, IRCCS San Raffaele Institute, 20132 Milan, Italy
Interests: frailty; respiratory dysfunction; sarcopenia; geriatrics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Despite acute disease resolutions, more than half of older people do not to recover preadmission functional levels after hospitalization. Bedrest and inflammation can cause acute sarcopenia, which is a risk factor for nosocomial-related disability. Mechanisms underpinning acute sarcopenia, its long-term consequences, screening and treatments have not yet been completely clarified.

It has recently become evident that the preservation of muscle health and functional status during hospital stay would be of paramount importance for older people. In this vulnerable population, hospitalizations represent major risks for adverse outcomes. Despite acute disease resolution, more than half of older people do not recover preadmission functional levels, even 1 year after hospital discharge. Moreover, their risk of novel disabilities, institutionalization and death increases after hospital discharge.

Poor patient mobility is one of the main causes of the development of nosocomial-related disability. Bedrest can induce skeletal muscle loss both in young and (to a greater extent) older individuals. In addition, inflammation, immune–endocrine dysregulations and reduced caloric intake further concur to acute muscle insufficiency during hospital stay. When this muscle insufficiency satisfies the criteria for the diagnosis of sarcopenia, it is named acute sarcopenia. Few studies have evaluated acute sarcopenia thus far, and further research on this topic is needed. 

Dr. Sarah Damanti
Guest Editor

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Keywords

  • wasting
  • malnutrition
  • loss of muscle mass
  • inflammation
  • hospitalization

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Published Papers (3 papers)

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Research

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12 pages, 506 KiB  
Article
Prevalence, Risk Factors, and Clinical Management of Disease-Related Malnutrition in Hospitalized Patients: A Descriptive Analysis Using GLIM and SGA Criteria
by Laura Mola Reyes, Rosa M. García-Moreno, Bricia López-Plaza and Samara Palma Milla
Nutrients 2024, 16(23), 4099; https://doi.org/10.3390/nu16234099 - 28 Nov 2024
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Abstract
Objectives: This study aimed to assess the prevalence and risk factors associated with disease-related malnutrition (DRM) in hospitalized patients using the Subjective Global Assessment (SGA) and Global Leadership Initiative on Malnutrition (GLIM) criteria. Additionally, we sought to identify key determinants of moderate and [...] Read more.
Objectives: This study aimed to assess the prevalence and risk factors associated with disease-related malnutrition (DRM) in hospitalized patients using the Subjective Global Assessment (SGA) and Global Leadership Initiative on Malnutrition (GLIM) criteria. Additionally, we sought to identify key determinants of moderate and severe malnutrition. Methods: A retrospective analysis was conducted on 1036 adult patients hospitalized in a tertiary care hospital between August 2019 and November 2020. Nutritional status was evaluated using both the SGA and GLIM criteria. Data on demographic characteristics, comorbidities, dietary intake, and gastrointestinal symptoms were collected. Logistic regression models were employed to identify risk factors for DRM, and multivariate analysis was used to determine independent predictors. Results: The prevalence of DRM was 63.3% according to GLIM and 64.8% according to SGA. Moderate malnutrition was observed in 22.6% of patients, while 40.7% were classified as having severe malnutrition, and severe weight loss was noted in 34.5% of the subjects. The key risk factors for DRM included male sex (OR 1.67, p < 0.0001), non-oncological gastrointestinal conditions (OR 1.48, p = 0.041), infectious diseases (OR 1.66, p = 0.007), inadequate ingestion (OR 5.13, p < 0.0001), and the presence of gastrointestinal symptoms (OR 3.06, p < 0.0001). Individualized diets were found to have a protective effect, while central parenteral nutrition significantly reduced the risk of severe DRM (OR 0.610, p = 0.014). In the final adjusted model, sex (p < 0.0001), ingestion (p < 0.0001), and gastrointestinal symptoms (p < 0.0001) emerged as the most significant independent predictors of DRM. Conclusions: The high prevalence of DRM in hospitalized patients emphasizes the importance of routine nutritional screening and personalized interventions. Proactive management of key risk factors such as inadequate intake and gastrointestinal symptoms is crucial to mitigating malnutrition and improving patient outcomes. Full article
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12 pages, 810 KiB  
Article
Prevalence and Characteristics of the Course of Dysphagia in Hospitalized Older Adults
by Ayano Nagano, Masami Onaka, Keisuke Maeda, Junko Ueshima, Akio Shimizu, Yuria Ishida, Shinsuke Nagami, Shuzo Miyahara, Keiji Nishihara, Akiyuki Yasuda, Shosuke Satake and Naoharu Mori
Nutrients 2023, 15(20), 4371; https://doi.org/10.3390/nu15204371 - 15 Oct 2023
Cited by 3 | Viewed by 2662
Abstract
Sarcopenic dysphagia (SD) is an emerging concern in geriatric medicine. This study aimed to identify the prevalence, progression, and distinct attributes of SD in patients in the Department of Geriatric Medicine. Older adult patients admitted between 2021 and 2022 were enrolled. The department [...] Read more.
Sarcopenic dysphagia (SD) is an emerging concern in geriatric medicine. This study aimed to identify the prevalence, progression, and distinct attributes of SD in patients in the Department of Geriatric Medicine. Older adult patients admitted between 2021 and 2022 were enrolled. The department conducts a comprehensive geriatric assessment (CGA) combined with a multidisciplinary team-based intervention, setting the standard for medical care. We diligently assessed the occurrence and development of dysphagia at both the admission and discharge phases. Of the 180 patients analyzed (38.9% male, mean age 86.0 ± 6.6 years), 22.8% were diagnosed with SD at admission, thrice the rate of other dysphagia variants. Only one patient had new-onset dysphagia during hospitalization, attributed to SD. Patients with SD showed a better recovery rate (18.9%) than those with other dysphagia types. Patients with diminished swallowing capacity had compromised nutritional profiles, diminished energy and protein consumption, and extended fasting durations. Although sarcopenia is a prevalent inducer of dysphagia in older adults, an integrated approach in geriatric medicine involving rehabilitation, nutrition, and dentistry is pivotal. Strategies rooted in CGA promise potential for addressing dysphagia. Full article
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Review

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41 pages, 1903 KiB  
Review
Acute Sarcopenia: Mechanisms and Management
by Sarah Damanti, Eleonora Senini, Rebecca De Lorenzo, Aurora Merolla, Simona Santoro, Costanza Festorazzi, Marco Messina, Giordano Vitali, Clara Sciorati and Patrizia Rovere-Querini
Nutrients 2024, 16(20), 3428; https://doi.org/10.3390/nu16203428 - 10 Oct 2024
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Abstract
Background: Acute sarcopenia refers to the swift decline in muscle function and mass following acute events such as illness, surgery, trauma, or burns that presents significant challenges in hospitalized older adults. Methods: narrative review to describe the mechanisms and management of acute sarcopenia. [...] Read more.
Background: Acute sarcopenia refers to the swift decline in muscle function and mass following acute events such as illness, surgery, trauma, or burns that presents significant challenges in hospitalized older adults. Methods: narrative review to describe the mechanisms and management of acute sarcopenia. Results: The prevalence of acute sarcopenia ranges from 28% to 69%, likely underdiagnosed due to the absence of muscle mass and function assessments in most clinical settings. Systemic inflammation, immune–endocrine dysregulation, and anabolic resistance are identified as key pathophysiological factors. Interventions include early mobilization, resistance exercise, neuromuscular electrical stimulation, and nutritional strategies such as protein supplementation, leucine, β-hydroxy-β-methyl-butyrate, omega-3 fatty acids, and creatine monohydrate. Pharmaceuticals show variable efficacy. Conclusions: Future research should prioritize serial monitoring of muscle parameters, identification of predictive biomarkers, and the involvement of multidisciplinary teams from hospital admission to address sarcopenia. Early and targeted interventions are crucial to improve outcomes and prevent long-term disability associated with acute sarcopenia. Full article
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