Prevalence of malnutrition and sarcopenia in Swiss rehabilitation settings
The study will collect for the first time national multicenter prevalence data on malnutrition and sarcopenia in the rehabilitation setting, highlighting the importance of the topic.
Factsheet
- Schools involved School of Health Professions
- Institute(s) Nutrition and Dietetics
- Funding organisation Others
- Duration 01.01.2022 - 31.07.2024
- Head of project Prof. Dr. Undine Lehmann
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Project staff
Prof. Dr. Undine Lehmann
Katja Uhlmann
Laura Marti -
Partner
Berner Reha Zentrum
REHAB Basel
Universitäre Altersmedizin FELIX PLATTER
Zürcher RehaZentren
Klinik Barmelweid AG - Keywords prevalence, malnutrition, sarcopenia, rehabilitation, multicenter study
Situation
Malnutrition and sarcopenia are common health problems in various populations, especially among older adults. They are associated with adverse outcomes such as higher complication rates, longer hospital stays, increased morbidity and mortality, and lower quality of life. There are few prevalence data available for malnutrition and sarcopenia, especially in rehabilitation hospitals and for different rehabilitation divisions and age groups. This study aims to fill this gap by both collecting prevalence data across multiple rehabilitation divisions and examining the progression of malnutrition and sarcopenia parameters during the rehabilitation stay.
Course of action
For the primary objective (prevalence study), a national multicenter cross-sectional study will be conducted in five rehabilitation centers in Switzerland. For the secondary objective (change in parameters during rehabilitation), a prospective multicenter observational study will be conducted. A total of 550 patients will be included across six rehabilitation divisions. Prevalence will be assessed according to international recommendations. This will initially include screening for malnutrition by determining the Nutritional Risk Score. Screening for sarcopenia is performed by a validated questionnaire (SARC-F), determination of handgrip strength and determination of the chair-stand test. If the screening result is positive, an assessment and determination of severity follows, during which other measurement parameters such as weight, body mass index (BMI), development of appetite, weight loss and estimation of meeting nutritional intake requirements, muscle mass and functionality are examined. In addition, changes in malnutrition and sarcopenia parameters (handgrip strength, body weight, BMI) and the measure of functional independence (FIM) between entry and discharge from rehabilitation will be collected as an indication of rehabilitation progress. The study is supported by Fresenius Kabi (Switzerland) AG.
Result
Data collection took place from 01.11.2022 – 31.03.2023. The study included 558 patients (51.8% male, median age 73.0 years). The overall prevalence of malnutrition and sarcopenia was 35.5 % (95 % CI 31.5, 39.6 %) and 32.7 % (95 % CI 28.8, 36.8 %), respectively. Patients in geriatric (51.0%), pulmonology (45.0%) and internal / oncological (43.0%) rehabilitation were particularly affected by the diagnosis of malnutrition. Patients at risk of malnutrition were estimated to lose an average of -1.14 kg (95% CI -1.64, -0.63) during rehabilitation. Regardless of the risk or diagnosis of malnutrition or sarcopenia, patients slightly increased their HGS and FIM. However, at the end of rehabilitation, malnourished or sarcopenic patients still had significantly lower body weight, HGS and FIM than patients without malnutrition (p<0.01). 37.3% of patients at risk and 35.4% of patients diagnosed with malnutrition did not receive group or individual nutritional counseling. The results were published in the Journal of Rehabilitation Medicine (see link below, https://doi.org/10.2340/jrm.v57.42215).
Looking ahead
The study aims to raise awareness about the importance of malnutrition and sarcopenia, the need of nutrition management during rehabilitation as well as adequate follow-up.
