Journal Article

Increased intramuscular adipose tissue of the quadriceps at admission is more strongly related to activities of daily living recovery at discharge compared to muscle mass loss in older patients with aspiration pneumonia

Akazawa, Naoki, Tamura, Kimiyuki, Hioka, Akemi, Hino, Toshikazu, Tamura, Wataru, Moriyama, Hideki, Tsuji, Ryota, Funai, Keita

2024

Overview

Background Recent studies reported that an increase in intramuscular adipose tissue of the quadriceps in older patients negatively affects the recovery of activities of daily living (ADL) more than the loss of muscle mass. However, whether intramuscular adipose tissue of the quadriceps in older patients with aspiration pneumonia is related to ADL recovery remains unclear. This study aimed to determine the relationship between intramuscular adipose tissue of the quadriceps and ADL recovery in older patients with aspiration pneumonia. Methods Thirty-nine older inpatients who were diagnosed with aspiration pneumonia participated in this prospective study. The main outcome of this study was ADL at discharge. ADL were assessed using the Barthel Index (BI). The intramuscular adipose tissue and muscle mass of the quadriceps were evaluated at admission using echo intensity and muscle thickness observed on ultrasound images. A multiple linear regression analysis was performed to confirm whether the quadriceps echo intensity was related to the BI score at discharge, even after adjusting for confounding factors. Results The medians [interquartile range] of the BI score at admission and discharge were 15.0 [0.0–35.0] and 20.0 [5.0–55.0], respectively. The BI score at discharge was significantly higher than that at admission ( p  = 0.002). The quadriceps echo intensity (β =  − 0.374; p  = 0.036) and BI score at admission (β = 0.601; p  < 0.001) were independently and significantly related to the BI score at discharge (R 2  = 0.718; f 2  = 2.546; statistical power = 1.000). In contrast, the quadriceps thickness (β =  − 0.216; p  = 0.318) was not independently and significantly related to the BI score at discharge. Conclusions Increased intramuscular adipose tissue of the quadriceps at admission is more strongly and negatively related to ADL recovery at discharge than the loss of muscle mass among older patients with aspiration pneumonia. Interventions targeting the intramuscular adipose tissue of the quadriceps may improve ADL among these patients. Highlights 1. We determined the relationship between intramuscular adipose tissue at admission and ADL recovery at discharge in patients with aspiration pneumonia. 2. Quadriceps echo intensity at admission was negatively related to the Barthel Index score at discharge. 3. Quadriceps thickness at admission was not related to the Barthel Index score at discharge. 4. Increase in intramuscular adipose tissue of the quadriceps at admission is negatively related to the recovery of ADL at discharge in patients with aspiration pneumonia.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Activities of Daily Living / Adipose tissue / Adipose Tissue - diagnostic imaging / Adipose tissues / Aged / Aged patients / Aging / Analysis / Aspiration pneumonia / Body fat / Care and treatment / Comparative analysis / Geriatrics/Gerontology / Health aspects / Humans / Intramuscular adipose tissue / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Mortality / Muscle mass / Muscle strength / Muscles / Nutritional status / Older people / Patient Discharge / Physiological aspects / Pneumonia / Pneumonia, Aspiration - diagnostic imaging / Prospective Studies / Quadriceps / Quadriceps muscle / Quadriceps Muscle - diagnostic imaging / Recovery (Medical) / Rehabilitation / Software / Ultrasonic imaging