The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
J Am Med Dir Assoc. 2014 Feb;15(2):150.e11-6. doi: 10.1016/j.jamda.2013.10.009. Epub 2013 Dec 2.
Whether the combination of obesity and low muscle strength (dynapenic-obesity) would cause greater impairment of the activities of daily living (ADL)/instrumental activities of daily living (IADL) than obesity alone and low muscle strength alone (dynapenia) remains unclear. The aim of this study was to reveal the possible independent and additive effects of dynapenia and obesity on ADL/IADL disability in an older Chinese population.
A cross-sectional study, including 616 community-dwelling older adults, was conducted in China from 2010 to 2012. Based on the World Health Organization Asian Criteria of Obesity and handgrip strength tertiles, 4 independent groups were identified as follows: nondynapenia/nonobesity, dynapenia alone, obesity alone, and dynapenic-obesity. The Katz Index of Independence in ADL was used to assess ADL disability, whereas 6 IADL items of the Older Americans Resources and Services (OARS) multidimensional functional assessment questionnaire were used to assess IADL disability.
The prevalence of ADL and IADL disability was 21.1% and 28.9% in the dynapenic-obesity group, 15.5% and 22.6% in the dynapenia alone group, 13.1% and 19.6% in the obesity alone group, and 11.9% and 12.9% in the nondynapenia/nonobesity group, respectively. After adjusting for the covariates, in comparison with the dynapenic-obesity group, the adjusted odds ratios (95% confidence interval) for ADL disability were 0.36 (0.13-0.73) in the nondynapenia/nonobesity group, 0.51 (0.20-0.78) in the dynapenia-alone group, and 0.40 (0.11-0.61) in the obesity-alone group. The corresponding data for IADL disability were 0.55 (0.20-0.93), 0.82 (0.39-0.98), and 0.61 (0.30-0.91), respectively.
Dynapenia, obesity, and dynapenic-obesity were associated with an increased risk of ADL/IADL disability. Dynapenic-obesity was associated with a greater risk of ADL/IADL disability in comparison with dynapenia or obesity alone.
肥胖和低肌肉力量（肌少症性肥胖）的组合是否比单纯肥胖和单纯低肌肉力量（肌少症）对日常生活活动（ADL）/工具性日常生活活动（IADL）的损害更大仍不清楚。本研究的目的是揭示肌少症和肥胖在中国老年人群体中对 ADL/IADL 残疾的可能独立和附加影响。
2010 年至 2012 年，在中国进行了一项横断面研究，纳入了 616 名社区居住的老年人。根据世界卫生组织亚洲肥胖标准和握力三分位数，确定了 4 个独立组：非肌少症/非肥胖、肌少症、肥胖和肌少症性肥胖。采用 Katz 日常生活活动独立性指数评估 ADL 残疾，采用老年人资源和服务（OARS）多维功能评估问卷的 6 项 IADL 项目评估 IADL 残疾。
在肌少症性肥胖组中，ADL 和 IADL 残疾的患病率分别为 21.1%和 28.9%，肌少症组分别为 15.5%和 22.6%，肥胖组分别为 13.1%和 19.6%，非肌少症/非肥胖组分别为 11.9%和 12.9%。在调整协变量后，与肌少症性肥胖组相比，非肌少症/非肥胖组 ADL 残疾的调整比值比（95%置信区间）为 0.36（0.13-0.73），肌少症组为 0.51（0.20-0.78），肥胖组为 0.40（0.11-0.61）。IADL 残疾的相应数据分别为 0.55（0.20-0.93）、0.82（0.39-0.98）和 0.61（0.30-0.91）。
肌少症、肥胖和肌少症性肥胖与 ADL/IADL 残疾风险增加相关。与单纯肥胖或肌少症相比，肌少症性肥胖与更大的 ADL/IADL 残疾风险相关。
