{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T16:09:44Z","timestamp":1792253384244,"version":"4.4.0"},"reference-count":36,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T00:00:00Z","timestamp":1642550400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Evidence is scarce regarding the polypharmacy in patients with sarcopenia. The aim of this study was to investigate the effect of deprescribing for polypharmacy on the improvement of nutritional intake and sarcopenia in older patients with sarcopenia. A retrospective cohort study was conducted with hospitalized older patients with sarcopenia undergoing rehabilitation after stroke. Study outcomes included energy intake, protein intake, handgrip strength (HG) and skeletal muscle mass index (SMI) at hospital discharge. To consider the effects of deprescribing for polypharmacy, we used multivariate analyses to examine whether the change in the number of medications during hospitalization was associated with outcomes. Of 361 patients after enrollment, 91 (mean age 81.0 years, 48.4% male) presented with sarcopenia and polypharmacy and were eligible for analysis. The change in the number of medications was independently associated with energy intake (\u03b2 = \u22120.237, p = 0.009) and protein intake (\u03b2 = \u22120.242, p = 0.047) at discharge, and was not statistically significantly associated with HG (\u03b2 = \u22120.018, p = 0.768) and SMI (\u03b2 = 0.083, p = 0.265) at discharge, respectively. Deprescribing was associated with improved nutritional intake in older sarcopenic patients with polypharmacy undergoing stroke rehabilitation.<\/jats:p>","DOI":"10.3390\/nu14030443","type":"journal-article","created":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T21:01:51Z","timestamp":1642626111000},"page":"443","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Deprescribing Leads to Improved Energy Intake among Hospitalized Older Sarcopenic Adults with Polypharmacy after Stroke"],"prefix":"10.3390","volume":"14","author":[{"given":"Ayaka","family":"Matsumoto","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7545-4179","authenticated-orcid":false,"given":"Yoshihiro","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0364-0818","authenticated-orcid":false,"given":"Hidetaka","family":"Wakabayashi","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Tokyo Women\u2019s Medical University Hospital, Tokyo 162-8666, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5094-2122","authenticated-orcid":false,"given":"Eiji","family":"Kose","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Teikyo University School of Medicine University Hospital, Tokyo 173-8606, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumihiko","family":"Nagano","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Bise","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshifumi","family":"Kido","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayuri","family":"Shimazu","sequence":"additional","affiliation":[{"name":"Department of Nutritional Management, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ai","family":"Shiraishi","sequence":"additional","affiliation":[{"name":"Department of Dental Office, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European Consensus on Definition and Diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1093\/ageing\/afy106","article-title":"The Prevalence of Sarcopenia in Community-Dwelling Older Adults, an Exploration of Differences between Studies and within Definitions: A Systematic Review and Meta-Analyses","volume":"48","author":"Mayhew","year":"2019","journal-title":"Age Ageing"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2022","DOI":"10.1016\/j.clnu.2017.09.009","article-title":"Prevalence of Sarcopenia and Its Association with Activities of Daily Living and Dysphagia in Convalescent Rehabilitation Ward Inpatients","volume":"37","author":"Yoshimura","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.jamda.2019.12.012","article-title":"Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment","volume":"21","author":"Chen","year":"2020","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.nut.2018.11.005","article-title":"Sarcopenia Is Associated with Worse Recovery of Physical Function and Dysphagia and a Lower Rate of Home Discharge in Japanese Hospitalized Adults Undergoing Convalescent Rehabilitation","volume":"61","author":"Yoshimura","year":"2019","journal-title":"Nutrition"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.clnu.2018.05.024","article-title":"ESPEN Guideline on Clinical Nutrition and Hydration in Geriatrics","volume":"38","author":"Volkert","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/s41999-020-00294-2","article-title":"Nutritional Status and Functionality in Geriatric Rehabilitation Patients: A Systematic Review and Meta-Analysis","volume":"11","author":"Wojzischke","year":"2020","journal-title":"Eur. Geriatr. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1016\/j.jamda.2020.03.029","article-title":"Sarcopenic Obesity Is Associated With Activities of Daily Living and Home Discharge in Post-Acute Rehabilitation","volume":"21","author":"Yoshimura","year":"2020","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"553.e1","DOI":"10.1016\/j.jamda.2017.03.019","article-title":"Interventions for Treating Sarcopenia: A Systematic Review and Meta-Analysis of Randomized Controlled Studies","volume":"18","author":"Yoshimura","year":"2017","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1111\/ggi.13322","article-title":"Chapter 4 Treatment of Sarcopenia","volume":"18","author":"Arai","year":"2018","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1007\/s12603-018-1139-9","article-title":"International Clinical Practice Guidelines for Sarcopenia (ICFSR): Screening, Diagnosis and Management","volume":"22","author":"Dent","year":"2018","journal-title":"J. Nutr. Health Aging"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1111\/ggi.13547","article-title":"Effects of Branched-Chain Amino Acids and Vitamin D Supplementation on Physical Function, Muscle Mass and Strength, and Nutritional Status in Sarcopenic Older Adults Undergoing Hospital-Based Rehabilitation: A Multicenter Randomized Controlled Trial","volume":"19","author":"Takeuchi","year":"2019","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.nut.2018.05.028","article-title":"Effects of a Leucine-Enriched Amino Acid Supplement on Muscle Mass, Muscle Strength, and Physical Function in Post-Stroke Patients with Sarcopenia: A Randomized Controlled Trial","volume":"58","author":"Yoshimura","year":"2019","journal-title":"Nutrition"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1038\/s41430-019-0450-9","article-title":"Weight Gain Is Associated with Improvement in Activities of Daily Living in Underweight Rehabilitation Inpatients: A Nationwide Survey","volume":"73","author":"Kokura","year":"2019","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"105017","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105017","article-title":"Muscle Mass Gain Is Positively Associated with Functional Recovery in Patients with Sarcopenia after Stroke","volume":"29","author":"Nagano","year":"2020","journal-title":"J. Stroke Cereb. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Yoshimura, Y., Wakabayashi, H., Momosaki, R., Nagano, F., Bise, T., Shimazu, S., and Shiraishi, A. (2021). Stored Energy Increases Body Weight and Skeletal Muscle Mass in Older, Underweight Patients after Stroke. Nutrients, 13.","DOI":"10.3390\/nu13093274"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e821","DOI":"10.3399\/bjgp12X659295","article-title":"Multimorbidity, Polypharmacy, Referrals, and Adverse Drug Events: Are We Doing Things Well?","volume":"62","year":"2012","journal-title":"Br. J. Gen. Pract."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.1111\/jgs.13153","article-title":"Health Outcomes Associated with Polypharmacy in Community-Dwelling Older Adults: A Systematic Review","volume":"62","author":"Fried","year":"2014","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"104520","DOI":"10.1016\/j.archger.2021.104520","article-title":"Sarcopenia and Polypharmacy among Older Adults: A Scoping Review of the Literature","volume":"98","author":"Pana","year":"2022","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.eurger.2017.04.009","article-title":"The Relationship between Polypharmacy and Recovery of Activities of Daily Living among Convalescent Stroke Patients: A Propensity Score-Matched Analysis","volume":"8","author":"Kose","year":"2017","journal-title":"Eur. Geriatr. Med."},{"key":"ref_21","first-page":"514","article-title":"Association of Polypharmacy with Nutritional Status, Functional Ability and Cognitive Capacity over a Three-Year Period in an Elderly Population","volume":"20","author":"Enlund","year":"2011","journal-title":"Pharm. Drug Saf."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e002736","DOI":"10.1136\/bmjopen-2013-002736","article-title":"The Eye Response Test Alone Is Sufficient to Predict Stroke Outcome--Reintroduction of Japan Coma Scale: A Cohort Study","volume":"3","author":"Shigematsu","year":"2013","journal-title":"BMJ Open"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1093\/ajcn\/82.4.777","article-title":"Geriatric Nutritional Risk Index: A New Index for Evaluating at-Risk Elderly Medical Patients","volume":"82","author":"Bouillanne","year":"2005","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.jpainsymman.2012.07.020","article-title":"Reliability and Validity of a Tool to Measure the Severity of Dysphagia: The Food Intake LEVEL Scale","volume":"46","author":"Kunieda","year":"2013","journal-title":"J. Pain Symptom Manag."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A New Method of Classifying Prognostic Comorbidity in Longitudinal Studies: Development and Validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J. Chronic. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1161\/01.STR.0000258355.23810.c6","article-title":"Outcomes Validity and Reliability of the Modified Rankin Scale: Implications for Stroke Clinical Trials: A Literature Review and Synthesis","volume":"38","author":"Banks","year":"2007","journal-title":"Stroke"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1016\/S0003-9993(96)90184-7","article-title":"The Reliability of the Functional Independence Measure: A Quantitative Review","volume":"77","author":"Ottenbacher","year":"1996","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2506","DOI":"10.1111\/ajt.12373","article-title":"Direct Segmental Multi-Frequency Bioelectrical Impedance Analysis Is Useful to Evaluate Sarcopenia","volume":"13","author":"Kaido","year":"2013","journal-title":"Am. J. Transplant."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1111\/j.1447-0594.2012.00868.x","article-title":"High Risk of Adverse Drug Reactions in Elderly Patients Taking Six or More Drugs: Analysis of Inpatient Database","volume":"12","author":"Kojima","year":"2012","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"By the 2019 American Geriatrics Society Beers Criteria\u00ae Update Expert Panel (2019). American Geriatrics Society 2019 Updated AGS Beers Criteria\u00ae for Potentially Inappropriate Medication Use in Older Adults: 2019 AGS BEERS CRITERIA\u00ae UPDATE EXPERT PANEL. J. Am. Geriatr. Soc., 67, 674\u2013694.","DOI":"10.1111\/jgs.15767"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1093\/ajcn\/63.4.491","article-title":"Evaluation of Four Methods for Determining Energy Intake in Young and Older Women: Comparison with Doubly Labeled Water Measurements of Total Energy Expenditure","volume":"63","author":"Sawaya","year":"1996","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"111091","DOI":"10.1016\/j.nut.2020.111091","article-title":"Frequent and Personalized Nutritional Support Leads to Improved Nutritional Status, Activities of Daily Living, and Dysphagia after Stroke","volume":"83","author":"Shimazu","year":"2021","journal-title":"Nutrition"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1111\/ggi.13561","article-title":"Change in Number of Potentially Inappropriate Medications Impacts on the Nutritional Status in a Convalescent Rehabilitation Setting","volume":"19","author":"Kose","year":"2019","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1007\/s12603-019-1283-x","article-title":"Anticholinergic Load and Nutritional Status in Older Individuals","volume":"24","author":"Kose","year":"2020","journal-title":"J. Nutr. Health Aging"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1111\/ggi.13975","article-title":"Rehabilitation Pharmacotherapy: A Scoping Review","volume":"20","author":"Kose","year":"2020","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s13539-014-0162-x","article-title":"Rehabilitation Nutrition for Sarcopenia with Disability: A Combination of Both Rehabilitation and Nutrition Care Management","volume":"5","author":"Wakabayashi","year":"2014","journal-title":"J. Cachexia Sarcopenia Muscle"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/3\/443\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:04:08Z","timestamp":1760133848000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/3\/443"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,19]]},"references-count":36,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["nu14030443"],"URL":"https:\/\/doi.org\/10.3390\/nu14030443","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,19]]}}}