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The Association Between Possible Sarcopenia and Delirium Onset in Older Patients With Acute Stroke
Kaori Shiozaki, Ayano Nagano, Mariko Hanaoka, Yuki Uchiyama, Kazuhisa Domen, Tetsuo Koyama. Cureus, 2025-06-29
Topic: Risk, prevention and care in population studies
Introduction Delirium is a common and serious complication among older adults hospitalized with acute stroke, and it is associated with increased morbidity, mortality, and prolonged hospital stays. Sarcopenia, characterized by a decline in muscle mass and strength, has emerged as a potential risk factor for delirium. However, there has been scarce research exploring this relationship in stroke populations. This study aimed to investigate the association between possible sarcopenia and the onset of delirium in older patients with acute stroke. Methods We conducted a retrospective cohort study of patients aged 65 years and older admitted to the Stroke Care Unit of a single institution between April 2020 and March 2021. Possible sarcopenia was defined using the AWGS2019 criteria based on grip strength and calf circumference. Delirium was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria by a certified dementia care team. Clinical characteristics and known delirium risk factors were extracted from medical records. Logistic regression analysis was performed to identify independent predictors of delirium. Results Of the 543 patients screened, 486 were included in the final analysis. Possible sarcopenia was identified in 187 patients (38.4%). Delirium occurred in 46 patients (9.4%), and its incidence was significantly higher in the sarcopenia group (15.0%) than in the non-sarcopenia group (6.0%, p=0.001). Multivariate logistic regression analysis revealed that possible sarcopenia was independently associated with delirium onset [odds ratio (OR): 1.98, 95% confidence interval (CI): 1.01-3.91, p=0.048], second only to a history of delirium. Conclusions Our findings suggest that possible sarcopenia is a significant and independent predictor of delirium in older patients with acute stroke. Early identification of sarcopenia may facilitate targeted interventions to reduce delirium risk and improve clinical outcomes in this vulnerable population.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Shiozaki, K., Nagano, A., Hanaoka, M., Uchiyama, Y., Domen, K., & Koyama, T. (2025). The Association Between Possible Sarcopenia and Delirium Onset in Older Patients With Acute Stroke. Cureus. https://doi.org/10.7759/cureus.86993
Vancouver
Shiozaki K, Nagano A, Hanaoka M, Uchiyama Y, Domen K, Koyama T. The Association Between Possible Sarcopenia and Delirium Onset in Older Patients With Acute Stroke. Cureus. 2025. doi:10.7759/cureus.86993. PMID: 40589442.
BibTeX
@article{shiozaki2025-40589442,
author = {Shiozaki, Kaori and Nagano, Ayano and Hanaoka, Mariko and Uchiyama, Yuki and Domen, Kazuhisa and Koyama, Tetsuo},
title = {{The Association Between Possible Sarcopenia and Delirium Onset in Older Patients With Acute Stroke}},
journal = {Cureus},
year = {2025},
doi = {10.7759/cureus.86993},
pmid = {40589442},
url = {https://doi.org/10.7759/cureus.86993}
}
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Key findings
- Introduction Delirium is a common and serious complication among older adults hospitalized with acute stroke, and it is associated with increased morbidity, mortality, and prolonged hospital stays.
- Results Of the 543 patients screened, 486 were included in the final analysis.
- Delirium occurred in 46 patients (9.4%), and its incidence was significantly higher in the sarcopenia group (15.0%) than in the non-sarcopenia group (6.0%, p=0.001).
- Multivariate logistic regression analysis revealed that possible sarcopenia was independently associated with delirium onset [odds ratio (OR): 1.98, 95% confidence interval (CI): 1.01-3.91, p=0.048], second only to a history of delirium.
- Conclusions Our findings suggest that possible sarcopenia is a significant and independent predictor of delirium in older patients with acute stroke.
Why it matters
This retrospective cohort study of older acute stroke patients found that delirium occurred more often in those with possible sarcopenia than in those without. It suggests possible sarcopenia may be a risk factor for delirium onset in this population.
Study details
- Study designcohort study
- Participants543
- Effect size38.4%; 9.4%; 15.0%
- Evidence strengthModerate
How this study scored 51/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Cureus) |
| Journal's citation record | 1 / 4 | Cureus: journal h-index 131 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 543 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 3 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 2.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 3 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Tetsuo Koyama: h-index 24 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Hyogo Medical University: institution h-index 355 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40589442) |
| Free to read | 2 / 2 | Free to read |
| Total | 51 / 100 | — |
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