Legrand Delphine, Vaes Bert, Matheï Catharina, Adriaensen Wim, Van Pottelbergh Gijs, Degryse Jean-Marie
Institut de Recherche Santé et Societé, Université Catholique de Louvain, Brussels, Belgium.
J Am Geriatr Soc. 2014 Jun;62(6):1030-8. doi: 10.1111/jgs.12840. Epub 2014 May 6.
To evaluate the predictive value of muscle strength and physical performance in the oldest old for all-cause mortality; hospitalization; and the onset of disability, defined as a decline in activities of daily living (ADLs), independent of muscle mass, inflammatory markers, and comorbidities.
A prospective, observational, population-based follow-up study.
Three well-circumscribed areas of Belgium.
Five hundred sixty participants aged 80 and older were followed for 33.5 months (interquartile range 31.1-35.6 months).
Grip strength, Short Physical Performance Battery (SPPB) score, and muscle mass were measured at baseline; ADLs at baseline and after 20 months; and all-cause mortality and time to first hospitalization from inclusion onward. Kaplan-Meier curves and Cox proportional hazards models were calculated for all-cause mortality and hospitalization. Logistic regression analysis was used to determine predictors of decline in ADLs.
Kaplan-Meier curves showed significantly higher all-cause mortality and hospitalization in subjects in the lowest tertile of grip strength and SPPB score. The adjusted Cox proportional hazards model showed that participants with high grip strength or a high SPPB score had a lower risk of mortality and hospitalization, independent of muscle mass, inflammatory markers, and comorbidity. A relationship was found between SPPB score and decline in ADLs, independent of muscle mass, inflammation, and comorbidity.
In people aged 80 and older, physical performance is a strong predictor of mortality, hospitalization, and disability, and muscle strength is a strong predictor of mortality and hospitalization. All of these relationships were independent of muscle mass, inflammatory markers, and comorbidity.
评估高龄老人肌肉力量和身体机能对全因死亡率、住院率以及残疾发生（定义为日常生活活动能力下降且与肌肉量、炎症标志物和合并症无关）的预测价值。
一项前瞻性、观察性、基于人群的随访研究。
比利时三个界限明确的地区。
560名80岁及以上的参与者接受了33.5个月的随访（四分位间距为31.1 - 35.6个月）。
在基线时测量握力、简短身体机能量表（SPPB）评分和肌肉量；在基线和20个月后测量日常生活活动能力；记录从纳入研究起的全因死亡率和首次住院时间。计算全因死亡率和住院率的Kaplan-Meier曲线及Cox比例风险模型。采用逻辑回归分析确定日常生活活动能力下降的预测因素。
Kaplan-Meier曲线显示，握力和SPPB评分处于最低三分位数的受试者全因死亡率和住院率显著更高。调整后的Cox比例风险模型显示，握力高或SPPB评分高的参与者死亡和住院风险较低，且与肌肉量、炎症标志物和合并症无关。发现SPPB评分与日常生活活动能力下降之间存在关联，且与肌肉量、炎症和合并症无关。
在80岁及以上人群中，身体机能是死亡率、住院率和残疾的有力预测指标，肌肉力量是死亡率和住院率的有力预测指标。所有这些关系均独立于肌肉量、炎症标志物和合并症。
