サルコペニアは自宅退院した脳卒中患者の手段的日常生活動作の実施状況を低下させる

Sarcopenia-induced reduction of instrumental activities of daily living among stroke patients discharged to home

要旨：本研究は，回復期から自宅退院した脳卒中患者の退院後のIADLとサルコペニアとの関連性を検証した後ろ向きコホート研究である．対象は2015〜2019年に当院を退院した脳卒中患者69名で，方法は退院1〜1.5ヵ月後に自宅訪問による追跡調査を行った．IADLの評価はFAIを，サルコペニアの評価はAWGSを用いた．退院時のサルコペニア有群は無群と比較し退院後FAIが有意に低かった．交絡因子を調整した多変量解析の結果，自宅退院した脳卒中患者のFAIにはサルコペニアが独立して関連していた．脳卒中患者のFAIの改善のために，サルコペニアの予防や改善を念頭に入れた作業療法が必要であると考えられた．

　This study retrospectively examined the association between post-discharge instrumental activities of daily living (IADL) and sarcopenia among post-stroke patients. The subjects were 69 stroke patients discharged from our hospital from 2015 to 2019, and all patients were surveyed by home visits 1 to 1.5 months after discharge. The IADL was evaluated using the Frenchay Activities Index (FAI), and sarcopenia was evaluated using the Asian Working Group for Sarcopenia. The FAI after discharge was significantly lower among the patients with sarcopenia at discharge than those without. Multivariate analysis adjusting for confounders showed that sarcopenia was independently associated with FAI among stroke patients discharged to home. In order to improve FAI in stroke patients, occupational therapy aimed at preventing or improving sarcopenia should be implemented.