Abstract Introduction Acute sarcopenia in hospitalised older adults is associated with poor outcomes, such as functional decline, increased risk of falls and prolonged hospital stays. Despite this, its development among older inpatients remains poorly understood. We aimed to quantify the effects of acute hospitalisation on sarcopenia outcomes in older adults. Methods Medline, Embase, CINAHL, and Web of Science were searched from inception until January 2025. Studies that included acutely admitted patients aged 65 years or older and reported changes in at least one measure of sarcopenia during hospitalisation were included. Barthel Index was also included. A random-effects meta-analysis was undertaken. Results Fifty-five eligible studies were included (n = 14,919 participants, mean age = 82.2 years). Grip strength significantly increased during hospitalisation (SMD = 0.23, 95% CI: 0.13; 0.33). No physical performance measure showed a significant change, and muscle mass decreased when measured using MRI or DEXA. Barthel Index significantly decreased during hospitalisation when using a pre-admission score as baseline (SMD = -0.66, 95% CI: −0.92; −0.39). Both age and hospital length of stay had no effect on grip strength or Barthel Index. Conclusions This review has shown that grip strength improves during hospitalisation and decreases in muscle mass are observed when measured using MRI or DEXA. Muscle strength and physical performance on admission are less suitable baseline measures, as they are often adversely affected during acute illness and, therefore, not representative of true baseline capacity. The lack of improvement in physical performance outcomes is an important finding as it represents failure to return to pre-hospital baseline abilities.
Cartledge et al. (2026) studied this question.
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