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根据欧洲老年人肌肉减少症工作组 (EWGSOP)的定义,与 dynapenia 相比,肌肉减少症是老年人残疾的一个风险因素。

Sarcopenia according to the european working group on sarcopenia in older people (EWGSOP) versus Dynapenia as a risk factor for disability in the elderly.

机构信息

Tiago da Silva Alexandre, University of São Paulo, Department of Epidemiology, Brazil,

出版信息

J Nutr Health Aging. 2014 May;18(5):547-53. doi: 10.1007/s12603-014-0465-9.

Abstract

BACKGROUND

Sarcopenia, defined as low muscle mass (LMM), and dynapenia have been associated with adverse outcomes in elderly.

OBJECTIVE

Contrast the association of sarcopenia versus dynapenia with incidence of disability.

DESIGN

A four-year prospective study (2006-2010).

SETTING

São Paulo, Brazil.

PARTICIPANTS

478 individuals aged 60 and older from the Saúde, Bem-Estar e Envelhecimento (SABE) study who were non-disabled at baseline.

MEASUREMENTS

Sarcopenia, measured according to the European Working Group on Sarcopenia in Older People (EWGSOP), includes: LMM assessed by skeletal muscle mass index ≤8.90kg/m2 (men) and ≤6.37kg/m2 (women); low muscle strength (LMS) assessed by handgrip strength <30kg (men) and <20kg (women); and low physical performance (LPP) assessed by gait speed ≤0.8m/s. Diagnosis of sarcopenia required LMM plus LMS or LPP. Dynapenia was defined as handgrip strength <30kg (men) and <20kg (women). Covariates included socio-demographic and behavioral variables, medical conditions, hospitalization, depressive symptoms, cognition, perception of vision, hearing and body mass index.

OUTCOMES

Disability in mobility or instrumental activities of daily living (IADL) or disability in activities of daily living (ADL) and IADL.

RESULTS

The incidence density of mobility or IADL disability was 43.4/1000 person/year and 22.6/1000 person/year for IADL and ADL disability. There was no significant difference in incidence density according sarcopenia or dynapenia status. After controlling for all covariates, sarcopenia was associated with mobility or IADL disability (relative risk ratio = 2.23, 95%Confidence Interval: 1.03-4.85). Dynapenia was not associated with disability.

CONCLUSIONS

Sarcopenia according to the EWGSOP definition can be used in clinical practice as a screening tool for early functional decline (mobility or IADL disability).

摘要

背景

肌少症(低肌肉量)和力量下降与老年人的不良结局相关。

目的

对比肌少症与力量下降与残疾发生率的关系。

设计

一项四年前瞻性研究(2006-2010 年)。

地点

巴西圣保罗。

参与者

来自 Saúde,Bem-Estar e Envelhecimento(SABE)研究的 478 名 60 岁及以上、基线时无残疾的个体。

测量方法

肌少症根据欧洲老年人肌少症工作组(EWGSOP)的标准进行测量,包括:肌肉质量指数(LMM)≤8.90kg/m2(男性)和≤6.37kg/m2(女性);握力(LMS)<30kg(男性)和<20kg(女性);以及步态速度(LPP)<0.8m/s。肌少症的诊断需要 LMM 加上 LMS 或 LPP。力量下降定义为握力<30kg(男性)和<20kg(女性)。协变量包括社会人口统计学和行为变量、医疗状况、住院、抑郁症状、认知、视力、听力和体重指数。

结果

移动或日常生活活动(IADL)残疾的发生率密度为 43.4/1000 人/年,IADL 和日常生活活动(ADL)残疾的发生率密度为 22.6/1000 人/年。根据肌少症或力量下降状况,发生率密度没有显著差异。在控制所有协变量后,肌少症与移动或 IADL 残疾相关(相对风险比=2.23,95%置信区间:1.03-4.85)。力量下降与残疾无关。

结论

根据 EWGSOP 定义的肌少症可作为早期功能下降(移动或 IADL 残疾)的筛查工具用于临床实践。

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