• Birgit Vahlberg, Lena Zetterberg, Birgitta Lindmark, Karin Hellström, and Tommy Cederholm.
• Physiotherapy, Department of Neuroscience, Uppsala University, Uppsala, Sweden. birgit.vahlberg@neuro.uu.se.
• BMC Geriatr. 2016 Feb 19; 16: 48.

BackgroundMuscle wasting and obesity may complicate the post-stroke trajectory. We investigated the relationships between nutritional status, body composition, and mobility one to 3 years after stroke.MethodsAmong 279 eligible home-dwelling individuals who had suffered a stroke (except for subarachnoid bleeding) 1-3 years earlier, 134 (74 ± 5 years, 69% men) were examined according to the Mini Nutritional Assessment-Short Form (MNA-SF, 0-14 points), including body mass index (BMI, kg/m(2)), body composition by bio-impedance analyses (Tanita BC-545), the Short Physical Performance Battery (SPPB, 0-12 points) combining walking speed, balance, and chair stand capacity, and the self-reported Physical Activity Scale for the Elderly (PASE).ResultsBMI ≥ 30 kg/m(2) was observed in 22% of cases, and 14% were at risk for malnutrition according to the MNA-SF. SPPB scores ≤ 8 in 28% of cases indicated high risk for disability. Mobility based on the SPPB was not associated with the fat-free mass index (FFMI) or fat mass index (FMI). Multivariate logistic regression indicated that low mobility, i.e., SPPB ≤ 8 points, was independently related to risk for malnutrition (OR 4.3, CI 1.7-10.5, P = 0.02), low physical activity (PASE) (OR 6.5, CI 2.0-21.2, P = 0.02), and high age (OR 0.36, CI 0.15-0.85, P = 0.02). Sarcopenia, defined as a reduced FFMI combined with SPPB scores ≤ 8 or reduced gait speed (<1 m/s), was observed in 7% of cases. None of the individuals displayed sarcopenic obesity (SO), defined as sarcopenia with BMI > 30 kg/m(2).ConclusionsNutritional disorders, i.e., obesity, sarcopenia, or risk for malnutrition, were observed in about one-third of individuals 1 year after stroke. Risk for malnutrition, self-reported physical activity, and age were related to mobility (SPPB), whereas fat-free mass (FFM) and fat mass (FM) were not. Nutrition and exercise treatment could be further evaluated as rehabilitation opportunities after stroke.

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