Sarcopenia is associated with incontinence and recovery of independence in urination and defecation in post-acute rehabilitation patients

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Vol. 91-92; p. 111397
• Main Authors: Kido, Yoshifumi, Yoshimura, Yoshihiro, Wakabayashi, Hidetaka, Momosaki, Ryo, Nagano, Fumihiko, Bise, Takahiro, Shimazu, Sayuri, Shiraishi, Ai
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2021; Elsevier Limited
• Subjects: Activities of Daily Living; Aged; Aged, 80 and over; Bladder; Cognitive ability; Convalescent rehabilitation; Defecation; Dysphagia; Fecal incontinence; Fecal Incontinence - epidemiology; Fecal Incontinence - etiology; Female; Hand Strength; Hospitalization; Hospitals; Humans; Hydration; Hypotheses; Incontinence; Intestine; Male; Middle Aged; Multivariate analysis; Muscles; Musculoskeletal system; Nutrition; Pacemakers; Patients; Recovery; Recovery (Medical); Regression analysis; Rehabilitation; Retrospective Studies; Sarcopenia; Sarcopenia - complications; Sarcopenia - rehabilitation; Sphincter; Statistical analysis; Stroke; Toileting independence; Treatment Outcome; Urinary incontinence; Urinary Incontinence - epidemiology; Urinary Incontinence - etiology; Urination; Urology; Womens health; Japan; Sarcopenia; Toileting independence; Activities of daily living; Incontinence; Convalescent rehabilitation; Urination; Defecation
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2021.111397

•Sarcopenia is negatively associated with recovery of urinary and defecation independence among patients undergoing convalescent rehabilitation after stroke.•Approximately 40% of the patients had decreased independence in urinary or defecatory activities, and the frequency was significantly higher in patients with sarcopenia than in others.•Early detection of sarcopenia and treatment with rehabilitation nutrition to predict and maximize improvement in toileting independence should be implemented in this population. The aim of this study was to examine the association between sarcopenia and recovery of independence in urination and defecation in patients undergoing convalescent rehabilitation. This single-center, retrospective cohort study included post-acute rehabilitation patients. Sarcopenia was diagnosed using the muscle mass index and handgrip strength according to the updated criteria of the Asian Working Group for Sarcopenia 2019. Study outcomes and the recovery of independence in urination and defecation were evaluated using the sphincter control items of the Functional Independence Measure (FIM) at discharge: urination (FIM-Bladder) and defecation (FIM-Bowel), respectively. Multivariate regression analyses were used to determine whether sarcopenia at baseline was associated with the study outcomes. Statistical significance was set at P < 0.05. After enrollment, 917 patients (mean age 74.7 ± 13.5 y; 58% women) were included in the final analyses. Sarcopenia was present in 451 patients (49.2%). The median FIM-Bladder and FIM-Bowel scores at admission were 5 [2-7] and 5 [3-7], respectively. Multivariate analyses showed that the presence of sarcopenia at admission was independently and negatively associated with FIM-Bladder and FIM-Bowel at discharge (all P < 0.001), respectively, after adjusting for potential confounders including baseline outcome variables, FIM, and disease. Sarcopenia was negatively associated with the recovery of independence in urination and defecation in a post-acute rehabilitation setting. This relationship was independent of physical and cognitive level and disease. Early detection of sarcopenia and treatment by rehabilitation nutrition should be implemented to predict and maximize improvement in toileting independence in this population.