Sarcopenia in older patients with idiopathic normal pressure hydrocephalus: an observational study from a single geriatric clinic in Turkey

Ali Ekrem Aydin; Fatma Sena Dost; Derya Kaya; Esra Ates Bulut; Feyza Mutlay; Ahmet Turan Isik

doi:10.1007/s13760-024-02583-0

Sarcopenia in older patients with idiopathic normal pressure hydrocephalus: an observational study from a single geriatric clinic in Turkey

Acta Neurol Belg. 2024 May 18. doi: 10.1007/s13760-024-02583-0. Online ahead of print.

Authors

Ali Ekrem Aydin¹, Fatma Sena Dost², Derya Kaya³, Esra Ates Bulut⁴, Feyza Mutlay⁵, Ahmet Turan Isik⁶

Affiliations

¹ Department of Geriatric Medicine, School of Medicine, Ondokuz Mayis University, Samsun, Turkey.
² Division of Geriatric Medicine, Darica Farabi Training and Research Hospital, Kocaeli, Turkey.
³ Unit for Brain Aging and Dementia, Department of Geriatric Medicine, School of Medicine, Dokuz Eylul University, Izmir, Turkey.
⁴ Department of Geriatric Medicine, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey.
⁵ Division of Geriatric Medicine, Van Training and Research Hospital, Van, Turkey.
⁶ Unit for Brain Aging and Dementia, Department of Geriatric Medicine, School of Medicine, Dokuz Eylul University, Izmir, Turkey. atisik@yahoo.com.

PMID: 38761330
DOI: 10.1007/s13760-024-02583-0

Abstract

Objective: Idiopathic normal pressure hydrocephalus (iNPH), a classical triad of gait abnormality, cognitive disturbance, and urinary incontinence, increases in prevalence with aging. Sarcopenia is also characterized by low muscle strength and mass, contributing to gait difficulty. Gait abnormality and lower physical activity also lead to the development of sarcopenia. Therefore, this study aims to investigate the relationship between sarcopenia and iNPH.

Methods: A total of 327 participants were included in this retrospective cross-sectional study. Demographic and clinical characteristics, including age, sex, comorbidity index, number of medications, recurrent falls in the last year, laboratory findings and comprehensive geriatric assessment (CGA) parameters were recorded. Sarcopenia was defined according to the EGWSOP2 criteria. The relationship between sarcopenia and iNPH was assessed with regression analysis.

Results: There were 51 participants with iNPH, 49% female, mean age 78 years (SD 5.7) and 276 control participants, 74% female, mean age 72 years (SD 6.1). The sarcopenia rates in patients with iNPH and controls were 19.6% and 2.5%, respectively (p < 0.01). The odds of probable sarcopenia were 3.89 times, and the slow gait speed was 8.47 times higher in iNPH patients than in controls after adjusting for age, sex, and the other confounders. The Mini-Mental State Examination score (p = 0.042, OR = 0.869 with 95% CI:0.759-0.995) was associated with probable sarcopenia among patients with iNPH.

Conclusion: This study demonstrated that sarcopenia was common in older patients with iNPH, which seems to be closely associated with decreased muscle strength and slowed gait speed. Thus, considering the potential untoward effects of both diseases, it is important for physicians to evaluate sarcopenia routinely in the follow-up and treatment of older patients with iNPH.

Keywords: Elderly; Gait; Muscle mass; Muscle strength; Normal pressure hydrocephalus.