Sarcopenia as a predictor of all-cause mortality among older nursing home residents: a systematic review and meta-analysis

OBJECTIVES: This study aims to review the evidence of sarcopenia as a predictor of all-cause mortality among nursing home residents. DESIGN: Systematic review and meta-analysis of observational cohort studies. DATA SOURCES: PubMed, EMBASE and the Cochrane Library databases were searched for relevant articles. PARTICIPANTS: Nursing home residents. PRIMARY AND SECONDARY OUTCOME MEASURES: All-cause mortality. DATA ANALYSIS: Summary-adjusted HRs or risk ratios (RRs) were calculated by fixed-effects model. The risk of bias was assessed by Newcastle-Ottawa Scale. RESULTS: Of 2292 studies identified through the systematic review, six studies (1494 participants) were included in the meta-analysis. Sarcopenia was significantly associated with a higher risk for all-cause mortality among nursing home residents (pooled HR 1.86, 95% CI 1.42 to 2.45, p<0.001, I(2)=0). In addition, the subgroup analysis demonstrated that sarcopenia was associated with all-cause mortality (pooled HR 1.87,95% CI 1.38 to 2.52, p<0.001) when studies with a follow-up period of 1 year or more were analysed; however, this was not found for studies with the follow-up period less than 1 year. Furthermore, sarcopenia was significantly associated with the risk of mortality among older nursing home residents when using bioelectrical impedance analysis to diagnosis muscle mass (pooled HR 1.88, 95% CI 1.39 to 2.53, p<0.001); whereas, it was not found when anthropometric measures were used to diagnosis muscle mass. CONCLUSION: Sarcopenia is a significant predictor of all-cause mortality among older nursing home residents. Therefore, it is important to diagnose and treat sarcopenia to reduce mortality rates among nursing home residents. PROSPERO REGISTRATION NUMBER: CRD42018081668