Prevalence of stroke-related sarcopenia and its association with poor oral status in post-acute stroke patients: Implications for oral sarcopenia

Background & aims: The aim of the study was to investigate the prevalence of stroke-related sarcopenia and its association with poor oral status in post-acute stroke patients. Methods: This cross-sectional study included 202 consecutive stroke patients who were admitted to convalescent rehabilitation wards in Japan. The Revised Oral Assessment Guide (ROAG) was used to assess oral status. Sarcopenia was defined as a loss of skeletal muscle mass index (SMI) with bioelectrical impedance and decreased muscle strength as measured by handgrip strength; cut-off values were adopted from the Asian Working Group for Sarcopenia. Univariate and multivariate analyses were applied to examine the associations between oral status, SMI, and HG. Results: Study participants included 107 males and 95 females with a mean age of 72 +/- 12 years. According to the ROAG, 82.2% of participants had slight to severe oral problems (median score: 11 [9-14]). The prevalence of stroke-related sarcopenia was 53.5%. Both SMI (mean: 6.1 +/- 1.3) and handgrip strength (median: 15 [7-25]) were significantly lower in the group with oral problems (SMI = 5.8 +/- 1.2, handgrip strength = 12 [6-20]) compared to individuals without oral problems (SMI = 7.4 +/- .8, handgrip strength = 27 123-341) (p < .001). The ROAG score was independently associated with SMI and handgrip strength, after adjusting for sex, age, stroke severity, activities of daily living, cognitive level, nutritional status, comorbidities, and time from stroke onset. Conclusions: Poor oral status was associated with sarcopenia, reduced muscle mass and strength in post acute stroke patients. Poor oral status and stroke-related sarcopenia were very common among the patients in this study, suggesting that healthcare providers should monitor for oral sarcopenia in post acute stroke patients. (C) 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.