Impact of Deprescribing Medications on Muscle Strength and Muscle Mass in Older Patients with Sarcopenia after Stroke

Polypharmacy is prevalent among older adults with sarcopenia and may negatively impact clinical outcomes. Although sarcopenia is associated with polypharmacy, the effect of deprescribing on muscle health in hospitalized patients with sarcopenia remains poorly understood. This study aimed to investigate the association between deprescribing during hospitalization and muscle strength and mass at discharge in sarcopenic patients after stroke. This study retrospectively analyzed data from a cohort of sarcopenic patients aged ≥65 years admitted to a convalescent rehabilitation ward after stroke. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia 2019 criteria. Deprescribing was defined as a reduction in the number of medications during hospitalization. The primary outcome was handgrip strength at discharge, and the secondary outcome was skeletal muscle mass index (SMI) at discharge. Multiple linear regression analyses were performed to examine the association between deprescribing and outcomes, adjusting for potential confounders. Of the 970 patients enrolled, 217 older patients, with a mean age of 81.8 years (males, 45.6%), were diagnosed with sarcopenia and included in the analysis. The median number of medications at admission was 5 (interquartile range 3-8), and 23.0% of patients experienced deprescribing during hospitalization. Deprescribing during hospitalization was independently associated with higher handgrip strength (β = 0.122, p = 0.009) and SMI (β = 0.138, p = 0.009) at discharge. Deprescribing was positively associated with improved muscle strength and mass at discharge in sarcopenic patients after stroke. These findings suggest that medication review and deprescribing may be beneficial strategies in the rehabilitation of sarcopenic stroke patients.