Poster Presentation 6th Annual Scientific Meeting of the Australian and New Zealand Society for Sarcopenia and Frailty Research 2024

Feasibility of implementing sarcopenia screening and intervention on an inpatient rehabilitation ward  (#8)

Tasha Koerner-Bungey 1 , Alison Hill 2 , Alexandra Day 1 , Cassandra Lawless 1
  1. Southern Adelaide Local Health Network (SALHN), ADELAIDE, SA, Australia
  2. University of South Australia, Adelaide, SA, Australia

Background
Sarcopenia is characterised by loss of muscle mass, strength and function leading to risk of falls/fractures, reduced independence, increased hospital admissions, length of stay, healthcare costs, and mortality. Currently there is no process for identifying sarcopenia in patients admitted to rehabilitation units in our local health network, missing an opportunity to optimise care.

Research aims/objectives
To evaluate the feasibility of implementing sarcopenia screening, diagnosis and intervention with high protein diet strategies, resistance exercise and education on an adult rehabilitation ward.

Methodology
A pathway was determined in accordance with the EWGSOP2 (2019) and ANZSSFR (2022) consensus guidelines. Allied health assistant (AHA) screened all admissions to the ward over 3 months. Screening involved handgrip strength, and if under range patients proceeded to have bioimpedance analysis (BIA). BIA measures muscle mass in a quick, portable manner to enable diagnosis of sarcopenia on the ward. Sarcopenia was diagnosed if BIA was under range. Once sarcopenia was confirmed, physiotherapy provided standard exercise program involving resistance exercise. Dietitians arranged high protein menu options and provided tailored sarcopenia education.

Results/findings
133 patients were screened (98% admissions). Mean age was 73 years (39-97yrs, SD± 11.9), with mean length of stay 19.4 days (1-85 days, SD± 13.6) in rehabilitation. 45 patients (34%) had low handgrip strength. Following BIA, 27% received sarcopenia management. BIA avoided over-diagnosis with 7.5% having appropriate muscle quantity. Majority (97%) engaged in resistance exercise 30min 3x week. Dietary intervention was accepted by 92%. Education was provided to 81% of patients.

Conclusions/evaluation
With a clear process, interdisciplinary teamwork, and staffing it is feasible and relevant to apply sarcopenia screening and management on inpatient rehabilitation units. Success of this study was in part due to funded AHA time, thus we are now presented with a translation gap for embedding sarcopenia practice on the wards in absence of dedicated staffing.
We acknowledge the Allied Health Scientific Office (ASHO), University South Australia and The Hospital Research Foundation for Research Grant support.

  1. Sobestiansky, S, Michaelsson, K, Cederholm, T 2019, Sarcopenia prevalence and associations with mortality and hospitalisation by various sarcopenia definitions in 85–89 year old community-dwelling men: a report from the ULSAM study, BMC Geriatrics, 19:318
  2. Hirani et al. 2015, Sarcopenia Is Associated With Incident Disability, Institutionalization, and Mortality in Community-Dwelling Older Men: The Concord Health and Ageing in Men Project, Journal of the American Medical Directors Association, vol. 16 iss. 7
  3. Yang et al. 2017, Sarcopenia predicts readmission and mortality in elderly patients in acute care wards: a prospective study, Journal of Cachexia Sarcopenia and Muscle, vol. 8, iss. 2, pp. 251-258
  4. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing 2019;48(1):16-31
  5. Zanker, J, Sim, M, Anderson, K, Balogun, S, Brennan-Olsen, S, Dent, E, Duque, G, Girgis, C.M., Grossmann, M, Hayes, A, Henwood, T, Hirani, V, Inderjeeth, C, Iuliano, S, Keogh, J, Lewis, J.R., Lynch, G.S., Pasco, J.A., Phu, S, Reijinierse, E.M., Russell, N, Vlietstra, L, Visvanathan, R, Walker, T, Waters, D.L., Yu, S, Maier, A.B., Daly, R.M. & Scott, D 2023, Consensus guidelines for sarcopenia prevention, diagnosis and management in Australia and New Zealand, Journal of Cachexia, Sarcopenia and Muscle, vol. 14, pp. 142-156