The evidence and impact of deprescribing on sarcopenia parameters: a systematic review
Notice bibliographique
Résumé
BACKGROUND: Polypharmacy (concomitant prescription of ≥ 5 medications) affects a third of older people, and evidence suggests an association with sarcopenia (loss of skeletal muscle mass/quality, muscle strength, and/or physical performance). As such, deprescribing has been recommended in routine management of sarcopenia, however it's unknown whether deprescribing is beneficial. This systematic review aimed to understand effects of deprescribing on sarcopenia parameters in older adults. METHODS: Medline, Embase, CINAHL, Web of Science, and the Cochrane Library databases were searched up to July 2023. All studies reporting effects of deprescribing interventions on sarcopenia parameters (primary outcomes) or nutritional intake (secondary outcomes) among older adults were included. Findings were summarised narratively, and study quality was assessed. RESULTS: A total of 4860 articles were identified and six were included (mean age range 67-87 years). Studies were heterogeneous in design, settings, follow-up periods, and outcomes. Deprescribing had no effect on skeletal muscle mass (n = 2). Positive effects were shown on handgrip strength with two studies reporting improvements following antihypertensive or benzodiazepines discontinuation and one showing no change between admission and discharge with general deprescribing. Outcomes of deprescribing on physical function outcomes varied based on the measures used. For example, one study showed no changes in timed up and go, Whereas effects on gait speed was contradictory in two studies, with preservation and deterioration reported. Two studies reported improvement between baseline and follow up in balance scores measured part of the Short physical performance battery or using the Short Berg's Balance Scale among those who discontinued antihypertensive and/or benzodiazepines. Two studies reported improvements in nutritional outcomes following deprescribing at hospital discharge, whereas two other studies reported no change or increase in weight loss. CONCLUSION: There is limited research about the impact of deprescribing on sarcopenia parameters. This systematic review found no significant changes in muscle mass but there is some evidence in improvements in strength, physical performance, and nutritional status with deprescribing. The multidisciplinary implementation of nutrition and exercise therapies, as well as medication management to modify polypharmacy, may further promote improvement in sarcopenia. However, more high-quality research is needed to understand the effects of deprescribing on sarcopenia parameters among older people including those with confirmed diagnosis of sarcopenia. REGISTRATION: The review was registered on the international prospective register of systematic reviews (PROSPERO, CRD42023417997).
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,003 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».