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Background <p>Muscle mass has recently been reported to be associated with survival and functional prognosis in older patients with pneumonia. However, it is unclear whether muscle quality and muscle mass affect the performance of activities of daily living (ADL) in older patients with pneumonia. Further, the impact of the overlap between muscle mass and muscle quality decline has not been established. The present study aimed to determine the effect of muscle mass and muscle quality, measured using chest computed tomography (CT), on ADL performance of older patients with pneumonia.</p> Methods <p>Nine hundred and twenty-two patients, diagnosed with pneumonia and admitted to Sanuki Municipal Hospital for pulmonary rehabilitation, were included. The cross-sectional area of the erector spinae muscle at the lower level of the 12th thoracic vertebra (ESM<sub>CSA</sub>) was used to represent muscle mass and the CT value of the erector spinae muscle (ESM<sub>CT</sub>) was used to represent muscle quality. ESM<sub>CSA</sub> was adjusted for body surface area (BSA). The motor functional independence measure (FIM) was to assess ADL performance, and &gt; 0.5 was used as the cutoff to judge the clinical outcome. Cutoff values for muscle mass and muscle quality were used to classify the participants into the following four groups: high muscle mass/muscle quality, low muscle mass, low muscle quality, and low muscle mass/muscle quality.</p> Results <p>The data of 373 participants were included in the analysis. Multiple logistic regression analysis using motor FIM effectiveness score as the dependent variable revealed that low muscle mass was still a significant independent variable after adjustment for confounding factors [odds ratio (OR), 0.43; 95% confidence interval (CI), 0.20–0.90]. The combination of low muscle mass and quality (OR, 0.14; 95% CI, 0.06–0.32) was a stronger influencing factor than low muscle mass alone.</p> Conclusions <p>The overlap of muscle mass and muscle quality loss in older patients with pneumonia markedly affects their ADL performance.</p>

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Association of muscle mass and quality with functional decline in older patients with pneumonia: single-center retrospective observational study in Japan

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月28日

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  • Yuichi Murakawa,
  • Akira Tamaki,
  • Ryota Matsuzawa,
  • Shinjiro Miyazaki,
  • Koji Fujishima,
  • Tatsuma Hori,
  • Miki Naide,
  • Kenichiro Sakai,
  • Tomoya Ishii

摘要

Background

Muscle mass has recently been reported to be associated with survival and functional prognosis in older patients with pneumonia. However, it is unclear whether muscle quality and muscle mass affect the performance of activities of daily living (ADL) in older patients with pneumonia. Further, the impact of the overlap between muscle mass and muscle quality decline has not been established. The present study aimed to determine the effect of muscle mass and muscle quality, measured using chest computed tomography (CT), on ADL performance of older patients with pneumonia.

Methods

Nine hundred and twenty-two patients, diagnosed with pneumonia and admitted to Sanuki Municipal Hospital for pulmonary rehabilitation, were included. The cross-sectional area of the erector spinae muscle at the lower level of the 12th thoracic vertebra (ESMCSA) was used to represent muscle mass and the CT value of the erector spinae muscle (ESMCT) was used to represent muscle quality. ESMCSA was adjusted for body surface area (BSA). The motor functional independence measure (FIM) was to assess ADL performance, and > 0.5 was used as the cutoff to judge the clinical outcome. Cutoff values for muscle mass and muscle quality were used to classify the participants into the following four groups: high muscle mass/muscle quality, low muscle mass, low muscle quality, and low muscle mass/muscle quality.

Results

The data of 373 participants were included in the analysis. Multiple logistic regression analysis using motor FIM effectiveness score as the dependent variable revealed that low muscle mass was still a significant independent variable after adjustment for confounding factors [odds ratio (OR), 0.43; 95% confidence interval (CI), 0.20–0.90]. The combination of low muscle mass and quality (OR, 0.14; 95% CI, 0.06–0.32) was a stronger influencing factor than low muscle mass alone.

Conclusions

The overlap of muscle mass and muscle quality loss in older patients with pneumonia markedly affects their ADL performance.