Prestroke Sarcopenia and Functional Outcomes in Elderly Patients Who Have Had an Acute Stroke: A Prospective Cohort Study

Objectives: The association between prestroke sarcopenia and functional outcomes in patients who have had a stroke has not, to our knowledge, been evaluated to date. We aimed to investigate the prevalence of prestroke sarcopenia, and determine whether prestroke sarcopenia is associated with functional outcomes in elderly patients who have suffered an acute stroke.

Methods: We assessed prestroke sarcopenia in elderly patients with acute stroke using the SARC-F questionnaire. Patients were divided into two groups according to their SARC-F score: non-sarcopenia (SARC-F score <4) and prestroke sarcopenia (SARC-F score ≥4). The study endpoint was the modified Rankin Scale score at 3 mo after the stroke (0-3, good outcome; 4-6, poor outcome). The Mann-Whitney U-test, Pearson χ test, Fisher exact test, and logistic regression were used in the statistical analyses.

Results: Of the 152 patients (81 men; median age [interquartile range]: 76 [11] y) enrolled, the prevalence rate of prestroke sarcopenia was 18% (27 patients). These 27 patients showed poor functional outcome at 3 mo after the stroke (50% versus 12%, prestroke sarcopenia versus nonsarcopenia; P < 0.001). After adjusting for variables, prestroke sarcopenia was an independent predictor of poor functional outcome at 3 mo after stroke (odds ratios: 7.39, 95% confidence interval: 1.47-37.21, P = 0.02).

Conclusions: Prestroke sarcopenia is an independent predictor of functional outcome at 3 mo after a stroke. Our findings highlight the importance of detecting prestroke sarcopenia in elderly patients with acute stroke.