A change in temporal muscle thickness is correlated with past energy adequacy in bedridden older adults: a prospective cohort study

BackgroundEnergy inadequacy has a great impact on health outcomes in older adult patients; however, it is difficult to evaluate energy adequacy in these patients, especially in home-care settings. We recently reported that temporal muscle thickness can be an indicator of nutritional status. The present study aims to examine whether a change in temporal muscle thickness is directly correlated with energy adequacy and, if so, to determine the cutoff value of a change in temporal muscle thickness to detect energy inadequacy.MethodsA prospective cohort study was conducted from September 2015 to June 2016 in two hospitals in Japan, and included bedridden older adult patients aged >= 65years. Temporal muscle thickness was measured using ultrasonography. Energy intake was estimated by photographic diet records. Total energy expenditure (TEE) was estimated by multiplying basal energy expenditure calculated using the Harris- Benedict equation by activity and stress factors. Energy adequacy was then calculated by dividing TEE by energy intake. Pearson's correlation coefficient was used to examine the relationship between percentage change in temporal muscle thickness and energy adequacy. Multiple logistic regression analysis was conducted to determine the direct relationship between percentage change in temporal muscle thickness and moderate energy inadequacy (energy adequacy<75%). Receiver operating characteristic (ROC) analysis was performed to determine the cutoff point for percentage change in temporal muscle thickness to detect moderate energy inadequacy.ResultsForty-eight patients were analyzed (mean age 84.47.8years; 54.2% were women). The percentage change in muscle thickness was significantly correlated with energy adequacy (r=0.733, p<0.001). ROC analysis identified a percentage change in temporal muscle thickness of -3.6% as the optimal cutoff point for detecting moderate energy inadequacy. Percentage change in muscle thickness was independently correlated with energy inadequacy after adjusting for age, sex, and masticatory status (AOR 0.281, 95% CI 0.125-0.635).Conclusions Changes in temporal muscle thickness are directly correlated with energy adequacy and can indicate moderate energy inadequacy in bedridden older adults. These results suggest the assessment of changes in temporal muscle thickness could be useful for guiding nutritional care in older adult patients in home-care settings.

Automated summary

This study aimed to evaluate the relationship between changes in temporal muscle thickness and energy adequacy in bedridden older adult patients. The results suggest that changes in temporal muscle thickness are directly correlated with energy adequacy, and can indicate moderate energy inadequacy in this population. The assessment of temporal muscle thickness changes may be useful for guiding nutritional care in home-care settings for older adult patients.