Sarcopenia, frailty prevalence, and related factors in patients with stroke: A cross-sectional analytical study from Turkey

Abstract

BACKGROUND: Sarcopenia and frailty may develop at varying rates depending on the metabolic, structural, and functional changes in the muscle structure after stroke. OBJECTIVE: To evaluate the prevalence of sarcopenia and frailty in patients with stroke and affecting clinical parameters. METHODS: This was a cross-sectional and analytical study. Twenty-six (49.1%) women and 27 men (50.9%) with stroke with an average age of 60.2 ± 10.3 (median = 62) years were included in the study. To evaluate physical performance, balance, and mobility, we used the 4-meter walk test (4-MWT), timed up and go test, chair sit and stand test, and the Berg Balance Scale (BBS). Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 criteria. The SARC-F scale was used for sarcopenia. RESULTS: The average stroke duration was 21.6 ± 18.2 months. Prefrailty was present in 14 (26.4%) patients, frailty was present in 34 (64.2%) patients, and two (3.8%) patients were normal. Sarcopenia was detected in 28 (52.8%) patients. According to handgrip strength, the prevalence of low muscle strength was 17% (n= 9). In the sarcopenic group, female sex (p= 0.005) was more frequent, 4-MWT was longer (p= 0.003), chair stand test results were lower (p< 0.001), the clinical frailty scale (CFS) was higher (p< 0.001), fall risk was higher compared with the BBS (p< 0.001), there was lower HG strength (p= 0.009), lower malnutrition scores (PNI, prognostic nutritional index, p< 0.001), and lower lymphocyte counts (p= 0.037). EAT-10 scores and dysphagia presence (p= 0.026), the presence of malnutrition (p< 0.021) and Nottingham Health Profile score (p< 0.001) were higher in the sarcopenic group. CONCLUSION: Sarcopenia and frailty frequently develop in patients with chronic stroke, with low lymphocyte counts, physical performance, muscle strength, and mobility and balance scores, and it is associated with poor prognostic factors including high disease severity, dysphagia, malnutrition, risk of falling, and poor quality of life.