INTRODUCTION: Hospitalization is associated with acute changes in sarcopenia status in older people, but the influencing factors are not fully understood. Pre-admission care dependency level as a risk factor has not yet been investigated. OBJECTIVE: Evaluate if pre-admission care dependency level is an independent predictor of sarcopenia changes following hospitalization. SETTING AND SUBJECTS: Data came from the Sarcopenia 9+ EAMA Project, a European prospective multi-centre study. For this study, 227 hospitalised older people were included from four different hospitals in Belgium, Spain and Poland, between 18 February 2019 and 5 September 2020. METHODS: Sarcopenia status at admission and discharge were calculated using a combined score (desirability value) based on muscle mass (calf circumference), strength (grip) and function (walking speed). Ratio of admission to discharge status was the outcome (desirability ratio; 1.00 meaning no difference). Predictor variable was the pre-admission care dependency level, classified into three groups: independent older people living at home, dependent older people living at home and older people living in a care home. Linear regression models were applied, considering potential confounders. RESULTS: Mean desirability ratio for dependent older people living at home ('middle dependent group') was lower (0.89) compared to independent older people (0.98; regression coefficient -0.09 [95% CI -0.16, -0.02]) and care home patients (1.05; -0.16 [95% CI -0.01, -0.31]). Adjusting for potential confounders or using another statistical approach did not affect the main results. CONCLUSION: Dependent older people living at home were at higher risk of deterioration in sarcopenia status following hospitalization. In-depth studies investigating causes and potential interventions of these findings are needed.

3rd Faculty of Medicine Charles University Prague Czech Republic

Agaplesion Bethesda Clinic Ulm Ulm Germany

Centro Hospitalar Lisboa Central Hospital de Santa Marta Lisbon Portugal

Clinical Research Unit Brugmann University Hospital Brussels Belgium

Department of Epidemiology Boston University School of Public Health Boston USA

Department of Geriatrics Faculty of Medicine and Health Sciences Ghent University Hospital Ghent Belgium

Department of Geriatrics Neurosciences and Orthopedics Catholic University of the Sacred Heart Rome Italy

Department of Healthcare for Older People Royal Devon and Exeter NHS Foundation Trust Exeter UK

Department of Internal Medicine and Gerontology Faculty of Medicine Jagiellonian University Medical College Kraków Poland

Division of Geriatrics Department of Internal Medicine Istanbul University Istanbul Turkey

Drug Quality and Registration group Faculty of Pharmaceutical Sciences Ghent University Ghent Belgium

Faculty of Medicine University Hospital Hradec Králové Hradec Králové Czech Republic

Geriatric Center Ulm Alb Donau Ulm University Ulm Germany

Geriatrics Department Rehabilitation Research Group Hospital del Mar Medical Research Institute Barcelona Spain

Institute of Clinical Rehabilitation University School of Physical Education Kraków Poland

Physical Medicine and Rehabilitation Department National Institute of Physical Medicine and Rehabilitation Panama city Panama

Physical Medicine and Rehabilitation Department Rehabilitation Research Group Hospital del Mar Medical Research Institute Universitat Autònoma de Barcelona Catalonia Spain

Unit for Molecular Immunology and Inflammation VIB Center for Inflammation Research Ghent Belgium

University of Exeter Medical School Exeter UK

WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging Division of Public Health Epidemiology and Health Economics University of Liège Liège Belgium

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