Lower skeletal muscle mass at admission independently predicts falls and mortality 3 months post-discharge in hospitalized older patients

Background: Approximately 10% of older adults is annually admitted to a hospital. Hospitalisation is associated with a higher risk of falls and mortality after discharge. This study aimed to identify predictors at admission for falls and mortality three months post-discharge in hospitalised older patients.

Methods: The EMPOWER study is an observational, prospective longitudinal inception cohort of 378 patients aged 70 years and older who were subsequently admitted to a tertiary hospital (the Netherlands). Potential predictors for falls and mortality three months post-discharge were tested using univariate and multivariate logistic regression analyses and included the following domains: demographic (age, sex, living independently), lifestyle (alcohol, smoking), nutrition (SNAQ score), muscle mass (absolute, relative), physical function (handgrip strength, Katz ADL score), cognition (6-CIT score) and disease (medications, diseases).

Results: The mean age was 79.6 years (standard deviation 6.23) and 50% were male. Within three months post-discharge, 19% reported a fall and 13% deceased. Univariate predictors for falls were higher age, lower absolute muscle mass and higher 6-CIT score. Lower absolute muscle mass independently predicted falls post-discharge (multivariate). Univariate predictors for mortality were higher age, male sex, no current alcohol use, higher SNAQ score, lower absolute and higher relative muscle mass, higher Katz ADL score and higher number of diseases. Male sex, higher SNAQ score and lower absolute muscle mass independently predicted mortality post-discharge (multivariate).

Conclusions: In hospitalised older adults, muscle mass should be measured to predict future outcome. Future intervention studies should investigate if increasing muscle mass prevent short term falls and mortality.