Menzies Research Institute, University of Tasmania, Hobart, Australia.
Arthritis Care Res (Hoboken). 2012 Jan;64(1):30-7. doi: 10.1002/acr.20545.
To examine the potential role of self-reported joint pain, stiffness, and dysfunction, and radiographic osteoarthritis (ROA), in sarcopenia progression and falls risk in older adults.
Seven hundred nine older adults (50% women, mean ± SD age 62 ± 7 years) were examined at baseline and followup (mean ± SD 2.6 ± 0.4 years). ROA was assessed using the Altman atlas, and pain at 7 anatomic sites was self-reported. Dual x-ray absorptiometry assessed leg lean mass, dynamometry assessed knee extension and whole leg strength, leg muscle quality (LMQ) was calculated as whole leg strength relative to leg lean mass, and the Physiological Profile Assessment assessed falls risk.
In women only, baseline knee pain predicted a greater decline in knee extension strength, whole leg strength, and LMQ, and a greater increase in falls risk. Severe knee pain, stiffness, and dysfunction predicted greater declines in knee extension strength and increases in falls risk (all P < 0.05). Hip pain also predicted a greater decline in knee extension strength (-1.53 kg; 95% confidence interval [95% CI] -2.95, -0.11). No associations were observed between pain and sarcopenia indicators in men. Somewhat surprisingly, higher baseline total knee ROA score predicted a greater increase in mean leg lean mass (0.05 kg; 95% CI 0.02, 0.08) in both sexes. A path analysis demonstrated that knee ROA may contribute to declines in LMQ in women, through increases in pain, stiffness, and dysfunction.
Knee and hip pain may directly contribute to the progression of sarcopenia and increased falls risk in older women.
探讨自我报告的关节疼痛、僵硬和功能障碍以及影像学骨关节炎（ROA）在老年人肌肉减少症进展和跌倒风险中的潜在作用。
709 名老年人（50%为女性，平均年龄±标准差为 62±7 岁）在基线和随访时（平均±标准差为 2.6±0.4 年）进行了检查。ROA 使用 Altman 图谱进行评估，7 个解剖部位的疼痛通过自我报告进行评估。双能 X 线吸收法评估腿部瘦体重，测力法评估膝关节伸展和整个腿部力量，腿部肌肉质量（LMQ）计算为整个腿部力量相对于腿部瘦体重，生理特征评估评估跌倒风险。
仅在女性中，基线膝关节疼痛预测了膝关节伸展力量、整个腿部力量和 LMQ 的更大下降，以及跌倒风险的更大增加。严重的膝关节疼痛、僵硬和功能障碍预测了膝关节伸展力量的更大下降和跌倒风险的增加（均 P<0.05）。髋关节疼痛也预测了膝关节伸展力量的更大下降（-1.53 公斤；95%置信区间[95%CI]-2.95，-0.11）。在男性中，疼痛与肌肉减少症指标之间没有观察到关联。令人有些惊讶的是，较高的基线全膝关节 ROA 评分预测了男女两性平均腿部瘦体重的更大增加（0.05 公斤；95%CI 0.02，0.08）。路径分析表明，膝关节 ROA 可能通过增加疼痛、僵硬和功能障碍，导致女性 LMQ 的下降。
膝关节和髋关节疼痛可能直接导致老年女性肌肉减少症的进展和跌倒风险的增加。
