Potentially inappropriate medications are negatively associated with functional recovery in patients with sarcopenia after stroke

Abstract

Background: Evidence is scarce for potentially inappropriate medications (PIMs) in rehabilitation medicine.

Aim: To examine the effect of PIMs on functional recovery in older patients with sarcopenia after stroke.

Methods: We conducted a retrospective cohort study in a post-acute rehabilitation hospital. All patients diagnosed with sarcopenia aged ≥ 65 years among all post-stroke patients hospitalized from 2015 to 2020 were included. PIMs were defined based on the 2019 Beers criteria. Sarcopenia was diagnosed using handgrip strength (HG) and skeletal muscle mass index (SMI), according to the criteria of the Asian Working Group for Sarcopenia 2019. The outcomes included functional independence measure motor (FIM-motor), HG, and SMI values at discharge. Multiple linear regression analyses were used to determine whether PIMs used at admission were independently associated with outcomes.

Results: Of the eligible patients, 361 were 65 years or older, of whom 196 (mean age 81.0 years, 44.4% male) presented with sarcopenia and were included in the analysis. Of these, 131 (66.8%) were prescribed PIMs at admission. The most frequently prescribed PIMs were proton pump inhibitors, antipsychotics, benzodiazepines, and nonsteroidal anti-inflammatory drugs. The number of PIMs on admission was independently associated with FIM-motor (β = - 0.132, P = 0.001) and HG (β = - 0.091, P = 0.048) at discharge, but not with SMI (β = - 0.055, P = 0.256).

Conclusions: High admission PIMs prescription numbers are negatively associated with favorable discharge functional status and muscle strength in older patients with sarcopenia after stroke.

Keywords: Muscle strength; Physical function; Potentially inappropriate medications; Rehabilitation; Sarcopenia.