Delirium is an acute confusional state marked by inattention and global cognitive dysfunction. It is multifactorial and develops owing to interactions between risk factors and noxious insults.¹ Common yet underdiagnosed, delirium is particularly prevalent among the hospitalized elderly, occurring in 29% to 64%, and contributes to more than $164 billion in health care costs in the United States annually.^1,2 Delirium significantly increases risk of falls, functional decline, dementia, prolonged hospital length of stay, and institutionalization.³ The strong correlation between delirium and hospital-related falls has led to calls for delirium prevention quality metrics to improve hospital care and prevent falls in older persons.⁴ Most important, at least 30% to 40% of delirium cases are preventable.^1,5,6 Surprisingly, most hospitals do not have delirium prevention programs or their protocols are inconsistently implemented, with variable adherence.^1,7

There is no consensus on the prevalence of sarcopenia or its impact on mortality in end‐stage renal disease patients undergoing dialysis. This review aimed to summarize the diagnostic criteria of sarcopenia and its prevalence and impact on the mortality of end‐stage renal disease patients undergoing dialysis. Embase, MEDLINE, PubMed, and Cochrane Library were searched from inception to 8 May 2021 to retrieve eligible studies that assessed muscle mass by commonly used instruments, such as dual‐energy X‐ray absorptiometry, bioelectrical impedance analysis, magnetic resonance imaging, and body composition monitor. Two assessment tools matched to study designs were employed to evaluate study quality. Pooled sarcopenia prevalence was calculated with 95% confidence interval (CI), and heterogeneity was estimated using the I² test. Associations of sarcopenia with mortality were expressed as hazard ratio (HR) and 95% CI. The search identified 3272 studies, and 30 studies (6162 participants, mean age from 47.5 to 77.5 years) were analysed in this review. The risk of bias in the included studies was low to moderate. Twenty‐two studies defined sarcopenia based on low muscle mass (LMM) plus low muscle strength and/or low physical performance, while eight studies used LMM alone. Muscle mass was assessed by different instruments, and a wide range of cut‐off points were used to define LMM. Overall, sarcopenia prevalence was 28.5% (95% CI 22.9–34.1%) and varied from 25.9% (I² = 94.9%, 95% CI 20.4–31.3%; combined criteria) to 34.6% (I² = 98.1%, 95% CI 20.9–48.2%; LMM alone) (P = 0.247 between subgroups). The statistically significant differences were not found in the subgroups of diagnostic criteria (P > 0.05) and dialysis modality (P > 0.05). Additionally, the sarcopenia prevalence could not be affected by average age [regression coefficient 0.004 (95% CI: −0.005 to 0.012), P = 0.406] and dialysis duration [regression coefficient 0.002 (95% CI −0.002 to 0.005), P = 0.327] in the meta‐regression. The pooled analyses showed that combined criteria of sarcopenia were related to a higher mortality risk [HR 1.82 (I² = 26.3%, 95% CI 1.38–2.39)], as was LMM [HR 1.61 (I² = 26.0%, 95% CI 1.31–1.99)] and low muscle strength [HR 2.04 (I² = 80.4%, 95% CI 1.19–3.5)]. Although there are substantial differences in diagnostic criteria, sarcopenia is highly prevalent in dialysis patients and is linked to increased mortality. The standardization of sarcopenia diagnostic criteria would be beneficial, and future longitudinal studies are needed to investigate the prevalence and prognostic value of sarcopenia in dialysis patients.

Background: Depression may be the most common cause of emotional distress later in life and can significantly reduce the quality of life in elderly individuals. Sarcopenia is a syndrome characterized by the continuous loss of skeletal muscle mass and decreased strength and function. In recent years, many studies have shown a correlation between sarcopenia and depression. The present study aimed to investigate the prevalence of depression among individuals with sarcopenia and to ascertain whether sarcopenia is independently associated with depression.Methods: We systematically searched the PubMed, Embase, and Google Scholar databases for papers on sarcopenia published up to 31 August 2021. We reviewed the literature on the number of individuals with sarcopenia, the number of individuals with both sarcopenia and depression, and the odds ratio (OR) of sarcopenia to depression. Statistical analyses were performed using Meta‐DiSc 1.4 software and Stata version 12.0.Results: Nineteen articles met the inclusion criteria for review: nine reported both prevalence and ORs, four described prevalence only, and six detailed the ORs only. Regarding prevalence, there were 1476 cases of sarcopenia and 364 of depression in the selected studies; the mean age of the patients was 75.5 years, and the overall prevalence of depression was 0.28 [95% confidence interval (CI): 0.21–0.36]. Significant heterogeneity was noted (P < 0.001; I² = 92.2%). In the case of ORs, there were 16 869 subjects with a mean age of 73 years; the overall adjusted OR between sarcopenia and depression was 1.57 (95% CI: 1.32–1.86). Significant heterogeneity was noted in the adjusted ORs (P < 0.001; I² = 75.1%).Conclusions: The prevalence of depression in patients with sarcopenia was high relatively, and there was a correlation between sarcopenia and depression.

In the era of longer life expectancy and advances in medical science and technology, the number of older adults receiving operations has increased. In the United States, about 50% of people older than 65 years undergo surgical procedures.¹ A similar trend is seen in mainland China, where 35% of operations are performed on older patients.² Postoperative delirium (POD) is one of the most common complications for older patients, with incidence rates ranging from 13% to 50%.³ As such, POD is associated with serious adverse outcomes, including increased length of hospital stay (LOS),⁴ mortality,⁵ risk of functional decline, and subsequent dementia.⁶ In the United States, annual health care costs for POD are estimated to be more than $182 billion.^7,8 However, previous studies have demonstrated that 30% to 40% of these cases are preventable.^9,10 Thus, effective prevention strategies for delirium can yield substantial benefits.