Abstract
Half of all physical disability among older adults arises during hospitalization. We examined whether sarcopenia is a risk factor for hospital-associated activity of daily living (ADL) disability in the Health ABC Study. Individuals hospitalized during the first 5 years of follow-up were analyzed (n=938 men, 841 women). Low appendicular lean mass to body mass index ratio (ALMBMI; <0.789 men, <0.512 women) and low grip strength (<26 kg men, <16kg women) were assessed at the annual visit prior to hospitalization. Hospital-associated ADL disability was defined as becoming unable or needing help to perform any of 5 ADLs (walking 1/4 mile, climbing 10 steps, getting in/out of bed/chairs, bathing, and dressing) or death at the next annual visit following hospitalization. Logistic regression modeled associations of pre-hospitalization low ALMBMI and low grip strength with development of ADL disability following hospitalization with and without adjusting for covariates (age, race, cognitive function, physical activity, smoking status, falls, and medical comorbidities). 17 % of men and 19% of women developed the primary outcome, including 10% of men and 8% of women who died. Low grip strength was associated with increased risk of worsening ADL function or death in men (adjusted OR: 2.1 (1.2–3.7)), but not in women (aOR: 1.2 (0.7–2.1). Low ALMBMI was not associated with worsening ADL function or death in men (aOR: 1.0 (0.6–1.5) or women (aOR: 1.1 (0.7–1.9). While future studies are needed, low grip strength appears to be an important risk factor for the development of hospital-associated ADL disability among older men.