The SyNApTIC Study – SarcopeNia, frAilTy, and malnutrition in geriatrIC rehabilitation

There is a high prevalence of geriatric syndromes in patients 65 years or older, notably in the rehabilitation setting. The number of patients with these syndromes range from up to 90% for frailty, up to 78% for sarcopenia, and up to 50% for malnutrition [1-5]. These geriatric syndromes have many overlapping diagnostic criteria; and due to the high prevalence of each, are likely to present in the same patient. Though research has explored the prevalence of these geriatric syndromes in acute and community settings, studies are lacking on the prevalence and trajectory of these geriatric syndromes in the rehabilitation setting [6, 7]. Best practice guidelines recommend that older adult inpatients should be assessed for frailty, sarcopenia, and malnutrition on admission to rehabilitation due to their negative impact on recovery, longevity, and quality of life [8], and as these geriatric syndromes are considered modifiable syndromes and therefore able to be improved with appropriate intervention during their rehabilitation stay [6, 9]. However, diagnostic tests may lead to patient burden due to duplication of unnecessary assessment.
This diagnostic accuracy study using prospective data in older adults admitted to Robina rehabilitation ward aims to assess the overlap between the three geriatric syndromes, and to determine which diagnostic assessment tool is the best predictor of patient-centred outcomes such as quality of life, length of stay, re-hospitalisations, in order to identify the most appropriate tool for assessing geriatric syndromes on admission to rehabilitation.

In geriatric patients (65 years or older) admitted to the rehabilitation ward of Robina Hospital:

1) What are the differential diagnostics of malnutrition assessed by the Scored PG-SGA, sarcopenia assessed by the EWGSOP2, and frailty assessed by the Edmonton Frail Scale and Frieds Phenotypic Criteria?

2) What is the predictive validity of the Scored PG-SGA (for diagnosing malnutrition), EWGSOP2 guidelines (for diagnosing sarcopenia), and Edmonton’s frailty index (for diagnosing frailty) for predicting patient outcomes including falls, infections, quality of life, function independence measure (FIM) scores, rehabilitation length of stay, pressure ulcers, re-hospitalisation, aged care admissions, and mortality?

malnutrition, sarcopenia and frailty in patients 65 y or older admitted to the rehabilitation ward of Robina Hospital