Association of Sarcopenia at Admission with Physical Performance at Discharge in Older Patients with Subacute Stroke:...

This study investigated whether sarcopenia at admission is independently associated with physical performance at discharge in older patients with stroke, after adjusting for stroke severity and other clinical variables.

This prospective cohort study included patients with stroke aged 65 years or older admitted to a rehabilitation hospital between November 2021 and August 2024. Sarcopenia was defined by Asian Working Group for Sarcopenia 2019 criteria (handgrip strength and skeletal muscle mass index). Physical performance was assessed using the Short Physical Performance Battery (SPPB) at admission and discharge. Multiple linear regression examined the association between sarcopenia and SPPB scores at discharge, adjusting for age, sex, body mass index, stroke type, premorbid modified Rankin Scale, Charlson Comorbidity Index, Brunnstrom recovery stage, National Institutes of Health Stroke Scale, and SPPB score at admission.

Of 198 patients screened, 145 were included in the final analysis (mean age, 76.9 ± 7.1 years; 74 were male), and 85 participants (58.6%) presented with sarcopenia. After adjustment, sarcopenia at admission was independently associated with lower SPPB scores at discharge (β = -0.123; 95% confidence interval: -1.874 to -0.066; P = 0.036). Age, premorbid modified Rankin Scale score, stroke severity, and admission SPPB score were also significant predictors of physical performance at discharge.

Sarcopenia is independently associated with poorer physical performance at discharge among older patients with stroke, even after accounting for stroke-related factors. Early identification and management of sarcopenia may allow optimization of rehabilitation outcomes in this demographic, although the clinical significance of this association warrants further investigation.