Possible Sarcopenia and Its Association with Nutritional Status, Dietary Intakes, Physical Activity and Health-Related Quality of Life Among Older Stroke Survivors

Background: Screening for sarcopenia in the stroke population is an emerging concept in research and clinical practice. Therefore, this cross-sectional study aimed to assess the prevalence of possible sarcopenia and its associated factors among older stroke survivors who visited the neurology and rehabilitation departments of three public hospitals in Malaysia.

Methods: We acquired data on sociodemographic characteristics, clinical profiles, malnutrition risk, dietary intake, physical activity level, and health-related quality of life. Possible sarcopenia was diagnosed in individuals with decreased calf circumference and low handgrip strength, as proposed by the Asia Working Group for Sarcopenia (2019). Finally, we performed descriptive analysis and binary logistic regression.

Results: Among 196 older adults with stroke (mean± standard deviation of age: 67.60 ± 5.70 years), 42.3% had possible sarcopenia, with a higher prevalence in the more advanced age group (≥70 years). In univariable analysis, possible sarcopenia was significantly associated with anthropometric indices, malnutrition risk, nutrient intake, physical activity level, and health-related quality of life. In multivariable analysis, body mass index (adjusted odds ratio [AOR]=0.57; 95% confidence interval [CI], 0.43-0.75) was the only factor associated with possible sarcopenia among individuals aged ≥70 years. Recurrent stroke (AOR=3.48; 95% CI, 1.02-11.92), body mass index (AOR=0.64; 95% CI, 0.54-0.76), and EQ-5D index (AOR=0.15; 95% CI, 0.03-0.78) were significantly associated with possible sarcopenia in the 60-69-year age group.

Conclusion: The prevalence of possible sarcopenia among community-dwelling older stroke survivors was high. Therefore, we recommend routine screening for possible sarcopenia to ensure early nutritional and exercise intervention.