ESPEN 2022 Abstract Submission

Topic: Geriatrics

Abstract Submission Identifier: ESPEN22-ABS-1891

ASSOCIATIONS BETWEEN FRAILTY AND ULTRASONOGRAPHIC THICKNESS OF ABDOMINAL WALL LAYERS IN OLDER ADULTS

M. Koca*, 1, M. Guner Oytun 1, A. Okyar Bas 1, S. Ceylan 1, Y. Ozturk 1, C. Balci 1, B. B. Dogu 1, M. Cankurtaran 1, M. Halil 1

1Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Türkiye

 

Rationale: Body composition was found to be among the predictors of outcomes for certain clinical conditions like cancer or transplantation. Computed tomography-based parameters like subcutaneous fat area, density and psoas muscle area were reported to be associated with long-term mortality after transcatheter aortic valve replacement (1). The aim of the present study was to examine whether there was any association between the ultrasonographic thickness of subcutaneous fat and muscle layers of abdominal wall and frailty scores of the older patients. 

Methods: The patients admitted to geriatrics outpatient clinic were included consecutively and data regarding comprehensive geriatric assessment (CGA) was recorded. Frailty status was determined according to Clinical Frailty Scale (CFS) and, gait speed, timed-up-and-go (TUG) and five times sit-to-stand tests were used to evaluate the physical performance. B-mode ultrasonographic measurements of the abdominal region were performed in relaxed and supine position for both the subcutaneous fat thickness (SFT) and for the thickness of rectus abdominis, external oblique, internal oblique, and transversus abdominis muscles individually. SFT was measured as the width beneath the skin to rectus abdominis muscle. Bioimpedance Analysis (BIA) was used for the body composition assessment.

Results: A total of 114 patients were analyzed. The mean (standard deviation) age of the study participants was 72.4 (5.9), and 66.7% was female. Data obtained with CGA, BIA and ultrasonographic measurements were compared for the robust patients (55%) and the patients living with prefrailty or frailty (45%) and the results were given in the table below. Robust group had significantly better scores for all components of CGA and physical performance assessment tools. Although anthropometrics and body composition parameters provided with BIA was similar between the groups, SFT was significantly lower for the patients living with prefrailty or frailty (P=0.036). The scores of CFS were negatively correlated with abdominal SFT (r= -0.217, P =0.021), and thickness of rectus abdominis (r= -0.313, P=0.001), external oblique (r= -0.294, P =0.002), and transversus abdominis (r= -0.274, P =0.003) muscles.

Table. Comparison of patient characteristics and measurements according to frailty status

 

Robust (CFS<4)

n=63

Prefrail&Frail (CFS≥4)

n=51

Total

 

n=114

P

Age (years) (mean, (SD))

69.9 (4.8)

75.4 (5.9)

72.4 (5.9)

<0.001*

Sex (female) (%(n))

58.7 (37)

76.5 (39)

66.7 (76)

0.046*

Lawton-Brody IADL (median, (IQR))

8 (0)

8 (3)

8 (1)

<0.001*

MNA-sf score (median, (IQR))

14 (1)

12 (5.5)

14 (3)

<0.001*

Handgrip strength (kg) (mean, (SD))

24.5 (7.6)

18.1 (5.8)

21.6 (7.5)

<0.001*

TUG (seconds) (median, (IQR))

9.1 (3.7)

13.0 (7.3)

10.0 (5.7)

<0.001*

Five times SST (seconds) (median, (IQR))

12.4 (5.5)

16.1 (6.2)

14 (5.8)

0.001*

BMI (kg/m2) (median, (IQR))

30.3 (5.4)

28.8 (6.9)

29.7 (5.7)

0.38

Waist circumference (cm) (mean, (SD))

97.5 (16.6)

95.9 (14.3)

96.7 (15.6)

0.56

Hip circumference (cm) (mean, (SD))

107.9 (9.6)

105.5 (10.1)

106.8 (9.8)

0.20

Fat percentage (%) (median (IQR))

36.7 (13.3)

36.6 (13.9)

36.7 (13.6)

0.78

BFMI (median (IQR))

10.7 (5.2)

10.4 (5.6)

10.6 (5.4)

0.94

Rectus abdominis (mm) (mean, (SD))

External oblique (mm) (mean, (SD))

Internal oblique (mm) (mean, (SD))

Transversus abdominis (mm) (mean, (SD))

9.0 (11.7)

3.9 (1.3)

6.1 (2.2)

4.1 (1.3)

6.4 (1.3)

3.2 (1.0)

5.4 (1.9)

3.5 (1.6)

7.9 (8.8)

3.6 (1.2)

5.8 (2.1)

3.9 (1.5)

0.11

0.003*

0.079

0.051

Subcutaneous fat (mm) (mean, (SD))

19.8 (10.7)

16.1 (7.6)

18.2 (9.7)

0.036*

Note. ADL: Activities of daily living, BFMI: Body fat mass index, BMI: Body mass index, CFS: Clinical frailty scale, IADL: Instrumental activities of daily living, IQR: Interquartile range, MNA-sf: Mini nutritional assessment-short form, SD: Standard deviation, SST: Sit-to-stand test, TUG: Timed-up-and-go 

Conclusion: Subcutaneous fat thickness obtained from abdominal region was significantly associated with frailty scores in older adults. Ultrasonographic measures of abdominal musculature and subcutaneous fat seems to represent a particular relation with frailty. 

References: 1.            Foldyna B, Troschel FM, Addison D, Fintelmann FJ, Elmariah S, Furman D, et al. Computed tomography-based fat and muscle characteristics are associated with mortality after transcatheter aortic valve replacement. Journal of Cardiovascular Computed Tomography. 2018;12(3):223-8.

 

Disclosure of Interest: None Declared

 

Keywords: adiposity, frailty, muscle ultrasound, Older adults, ultrasound measurements