| Association of cachexia with activities of daily living and discharge destinations among inpatients with dysphagia in a convalescent rehabilitation phase; A multi-center cohort study |
Shintaro Togashi1,2 
, Tomoyuki Murakami3, Hidetaka Wakabayashi4, Akio Shimizu5,6, Shinta Nishioka7, Ryo Momosaki5 |
1Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Wako‐shi, 351‐0197, Japan
2Department of Nursing Care, Sendai Kosei Hospital, Sendai, 980-0873, Japan
3Department of Rehabilitation, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Sendai, 984-8560, Japan
4Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Shinjuku, 162-8666, Japan
5Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Tsu, 514-8507, Japan
6Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, 480-1103, Japan
7Department of Clinical Nutrition and Food Service, Nagasaki Rehabilitation Hospital, Nagasaki, 850-0854, Japan |
Correspondence:
Shintaro Togashi,
Email: togashishintaro.42@gmail.com
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Received: 29 March 2025 • Revised: 26 June 2025 • Accepted: 10 September 2025 |
| Abstract |
Background
Although a recent study reported an association between cachexia, as defined by the Asian Working Group for Cachexia (AWGC), and lower functional recovery at discharge among post-stroke patients capable of oral intake during the convalescent rehabilitation phase, its impact on functional recovery in patients with dysphagia remains unclear. This study aimed to evaluate the association between cachexia, according to AWGC criteria, and both functional status and discharge destinations among inpatients with dysphagia.
Methods
This prospective cohort study enrolled 198 inpatients with dysphagia from eight convalescent rehabilitation hospitals. Cachexia was defined using the AWGC criteria at baseline. The primary outcome was the total Functional Independence Measure (FIM) at discharge, while the secondary outcomes were the Food Intake LEVEL Scale (FILS) score and discharge destinations. We applied generalized linear models to evaluate the association between cachexia and total FIM score at discharge, adjusting for age, sex, baseline FILS score, comorbidities, and use of enteral nutrition.
Results
Of 198 patients, the median age was 83.0 (interquartile range, 77.0 to 88.0) years; 111 (56.1%) were women, and 33 (16.7%) had cachexia. After adjusting for covariates, cachexia was not significantly associated with total FIM score at discharge (β = 0.03 [95% CI, –0.10 to 0.15], p = 0.66), FILS (β = 0.23 [95% CI, –0.53 to 1.00], p = 0.55), or discharge destinations including discharge to home (β = 0.25 [95% CI, –0.75 to 1.35], p = 0.63).
Conclusions
Cachexia, as defined by the AWGC, was not significantly associated with either functional status at discharge or discharge destinations among inpatients with dysphagia undergoing convalescent rehabilitation. |
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