Study Objectives Sarcopenia is a progressive disease characterized by the loss of muscle mass and decline in muscle function, with a prevalence exceeding 20% among the elderly population aged 65 years and older in Taiwan. The deterioration of muscle mass and functional performance eventually leads to adverse health outcomes, including increased risk of mortality. Apart from aging, the etiology of sarcopenia involves various factors such as nutrition, physical activity, and underlying diseases. Stroke is one of the leading causes of death and disability both in Taiwan and globally. In recent years, the population of post-stroke survivors has been aging rapidly, with a trend toward earlier onset of first-ever strokes.
"Stroke-related sarcopenia" refers to sarcopenia induced by stroke or an exacerbation of pre-existing sarcopenia, which negatively impacts clinical outcomes in stroke patients. Previous studies have investigated sarcopenia-related measures in stroke survivors, such as handgrip strength and calf circumference; however, these studies often utilized a single approach. To the best of our knowledge, no comprehensive analysis of these sarcopenia-related variables has been conducted. Furthermore, muscle strength in humans begins to decline around the age of 40, and this physiological deterioration may differ by sex. Limited research has compared the various sarcopenia indicators between post-acute care (PAC) and chronic stroke patients.
The objectives of this study are as follows:
To analyze the characteristics of sarcopenia-related variables assessed using different clinical measurement tools in post-acute and chronic stroke patients.
To examine the characteristics of these variables across different age groups (40-65 years and \>65 years), sexes, and stroke severity levels.
Expected Outcomes The prevalence of sarcopenia in both post-acute and chronic stroke patients is anticipated to be higher than that in the general elderly community.
Chronic stroke patients are expected to exhibit a slightly higher prevalence of sarcopenia compared to post-acute care stroke patients.
Older stroke patients (\>65 years) are expected to have a higher prevalence of sarcopenia compared to younger stroke patients (40-65 years).
Methods
This study is designed as a cross-sectional observational study and will be conducted at the Ministry of Health and Welfare Qishan Hospital. Participants will include stroke patients aged 40 years or older who have sufficient cognitive and physical abilities to complete sarcopenia screening and related questionnaires. Participants will be divided into two groups:
Group 1: Chronic stroke patients (n ≥ 75) Group 2: Stroke patients recently admitted to post-acute care wards (n ≥ 25) The recruitment will follow a 3:1 allocation ratio.
All participants will undergo both objective and subjective assessments:
Objective assessments: Sarcopenia-related indicators, including body composition, quadriceps strength, muscle thickness of the quadriceps and gastrocnemius via ultrasound, calf circumference, dominant hand grip strength, walking speed, the SARC-F questionnaire, and the Mini Nutritional Assessment.
Subjective assessment: EQ-5D questionnaire to evaluate health-related quality of life.
After data collection, the data will be entered and analyzed statistically to compare the prevalence and characteristics of sarcopenia between different stroke populations (post-acute care vs. chronic stroke; older vs. younger stroke patients).
