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肌少症作为老年人跌倒的风险因素:来自 ilSIRENTE 研究的结果。

Sarcopenia as a risk factor for falls in elderly individuals: results from the ilSIRENTE study.

机构信息

Department of Gerontology and Geriatrics, Catholic University of Sacred Heart, Roma, Italy.

出版信息

Clin Nutr. 2012 Oct;31(5):652-8. doi: 10.1016/j.clnu.2012.02.007. Epub 2012 Mar 11.

Abstract

BACKGROUND & AIMS: Sarcopenia has been indicated as a reliable marker of frailty and poor prognosis among the oldest individuals. We evaluated the relationship between sarcopenia and 2-year risk of falls in a population of persons aged 80 years or older.

METHODS

Data are from the baseline and follow-up evaluations of the Aging and Longevity Study in the Sirente Geographic Area (ilSIRENTE Study) (n=260). According to the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopenia was diagnosed in presence of low muscle mass (mid-arm muscle circumference) plus either low muscle strength (hand grip) or low physical performance (4-m walking speed). The primary outcome measure was the incident falls during the follow-up period of 2 years. The relationship between sarcopenia and incident falls was estimated by deriving hazard ratios (HRs) from multiple logistic regression models considering the dependent variable of interest at least one fall during the follow-up period.

RESULTS

Sixty-six participants (25.4%) were identified as affected by sarcopenia. Eighteen out of 66 (27.3%) participants with sarcopenia and 19 out of 194 (9.8%) without sarcopenia reported incident falls during the two-year follow-up of the study (p<0.001). After adjusting for age, gender, cognitive impairment, ADL impairment, sensory impairments, BMI, depression, physical activity, cholesterol, stroke, diabetes, number of medications, and C-reactive protein, participants with sarcopenia had a higher risk of incident falls compared with non sarcopenic subjects (adjusted hazard ratio [HR], 3.23; 95% confidence interval [CI], 1.25-8.29).

CONCLUSIONS

The present study suggests that sarcopenia - assessed using the EWGSOP algorithm - is highly prevalent among elderly persons without gender differences (25%). Sarcopenic participants were over three times more likely to fall during a follow-up period of 2 years relative to non sarcopenic individuals, regardless of age, gender and other confounding factors.

摘要

背景与目的

在老年人中,肌少症已被证明是衰弱和预后不良的可靠标志物。我们评估了肌少症与 80 岁及以上人群 2 年跌倒风险之间的关系。

方法

数据来自 Sirente 地理区域老龄化和长寿研究(ilSIRENTE 研究)的基线和随访评估(n=260)。根据欧洲老年人肌少症工作组(EWGSOP),肌少症的诊断标准为低肌肉量(中臂肌围),或同时存在低肌肉力量(握力)或低身体表现(4 米步行速度)。主要结局指标是随访期间发生的跌倒事件。通过多因素逻辑回归模型,考虑至少在随访期间发生一次跌倒的因变量,得出风险比(HR),以评估肌少症与跌倒事件的关系。

结果

66 名参与者(25.4%)被诊断为肌少症。在 66 名肌少症患者中,有 18 人(27.3%)和 194 名非肌少症患者(9.8%)在研究的两年随访期间报告发生了跌倒事件(p<0.001)。在校正年龄、性别、认知障碍、ADL 障碍、感觉障碍、BMI、抑郁、身体活动、胆固醇、中风、糖尿病、药物数量和 C 反应蛋白后,与非肌少症患者相比,肌少症患者发生跌倒事件的风险更高(校正后的 HR,3.23;95%置信区间 [CI],1.25-8.29)。

结论

本研究表明,使用 EWGSOP 算法评估的肌少症在无性别差异的 80 岁以上老年人中非常普遍(25%)。在 2 年的随访期间,与非肌少症个体相比,肌少症患者跌倒的可能性增加了三倍以上,无论年龄、性别和其他混杂因素如何。

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