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The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017
INTRODUCTION: Delirium and sarcopenia are common, although underdiagnosed, geriatric syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low sk...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8847195/ https://www.ncbi.nlm.nih.gov/pubmed/34417734 http://dx.doi.org/10.1007/s40520-021-01950-8 |
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author | Zucchelli, Alberto Manzoni, F. Morandi, A. Di Santo, S. Rossi, E. Valsecchi, M. G. Inzitari, M. Cherubini, A. Bo, M. Mossello, E. Marengoni, A. Bellelli, G. |
author_facet | Zucchelli, Alberto Manzoni, F. Morandi, A. Di Santo, S. Rossi, E. Valsecchi, M. G. Inzitari, M. Cherubini, A. Bo, M. Mossello, E. Marengoni, A. Bellelli, G. |
author_sort | Zucchelli, Alberto |
collection | PubMed |
description | INTRODUCTION: Delirium and sarcopenia are common, although underdiagnosed, geriatric syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. METHODS: The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. RESULTS: A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p < 0.001]. DISCUSSION AND CONCLUSION: Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40520-021-01950-8. |
format | Online Article Text |
id | pubmed-8847195 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-88471952022-02-23 The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017 Zucchelli, Alberto Manzoni, F. Morandi, A. Di Santo, S. Rossi, E. Valsecchi, M. G. Inzitari, M. Cherubini, A. Bo, M. Mossello, E. Marengoni, A. Bellelli, G. Aging Clin Exp Res Original Article INTRODUCTION: Delirium and sarcopenia are common, although underdiagnosed, geriatric syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. METHODS: The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. RESULTS: A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p < 0.001]. DISCUSSION AND CONCLUSION: Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40520-021-01950-8. Springer International Publishing 2021-08-20 2022 /pmc/articles/PMC8847195/ /pubmed/34417734 http://dx.doi.org/10.1007/s40520-021-01950-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Zucchelli, Alberto Manzoni, F. Morandi, A. Di Santo, S. Rossi, E. Valsecchi, M. G. Inzitari, M. Cherubini, A. Bo, M. Mossello, E. Marengoni, A. Bellelli, G. The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017 |
title | The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017 |
title_full | The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017 |
title_fullStr | The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017 |
title_full_unstemmed | The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017 |
title_short | The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017 |
title_sort | association between low skeletal muscle mass and delirium: results from the nationwide multi-centre italian delirium day 2017 |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8847195/ https://www.ncbi.nlm.nih.gov/pubmed/34417734 http://dx.doi.org/10.1007/s40520-021-01950-8 |
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