Sarcopenia as a predictor of all-cause mortality among older nursing home residents: a systematic review and meta-analysis

Objectives This study aims to review the evidence of sarcopenia as a predictor of all-cause mortality among nursing home residents. Design Systematic review and meta-analysis of observational cohort studies. Data sources PubMed, EMBASE and the Cochrane Library databases were searched for relevant articles. Participants Nursing home residents. Primary and secondary outcome measures All-cause mortality. Data analysis Summary-adjusted HRs or risk ratios (RRs) were calculated by fixed-effects model. The risk of bias was assessed by Newcastle-Ottawa Scale. Results Of 2292 studies identified through the systematic review, six studies (1494 participants) were included in the meta-analysis. Sarcopenia was significantly associated with a higher risk for all-cause mortality among nursing home residents (pooled HR 1.86, 95% CI 1.42 to 2.45, p<0.001, I-2=0). In addition, the subgroup analysis demonstrated that sarcopenia was associated with all-cause mortality (pooled HR 1.87,95% CI 1.38 to 2.52, p<0.001) when studies with a follow-up period of 1year or more were analysed; however, this was not found for studies with the follow-up period less than 1year. Furthermore, sarcopenia was significantly associated with the risk of mortality among older nursing home residents when using bioelectrical impedance analysis to diagnosis muscle mass (pooled HR 1.88, 95%CI 1.39 to 2.53, p<0.001); whereas, it was not found when anthropometric measures were used to diagnosis muscle mass. Conclusion Sarcopenia is a significant predictor of all-cause mortality among older nursing home residents. Therefore, it is important to diagnose and treat sarcopenia to reduce mortality rates among nursing home residents. PROSPERO registration number CRD42018081668