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老年人肌肉减少症评估中不同诊断标准的适用性与一致性

Applicability and agreement of different diagnostic criteria for sarcopenia estimation in the elderly.

作者信息

Pagotto Valéria, Silveira Erika Aparecida

机构信息

Federal University of Goiás, Nursing School, 227th, Block 68, s/n, Leste Universitário, Goiânia, Goiás, Brazil.

Faculty of Medicine, Federal University of Goiás, Health Science Graduate Program, 227th, Block 68, s/n, Leste Universitário, Goiânia, Goiás, Brazil.

出版信息

Arch Gerontol Geriatr. 2014 Sep-Oct;59(2):288-94. doi: 10.1016/j.archger.2014.05.009. Epub 2014 May 29.

Abstract

The purpose of this study cross-sectional study comprising 132 community dwelling elderly (≥ 60 years) was to identify sarcopenia prevalence in the Brazilian elderly, utilizing different diagnostic criteria and analyze agreement between criteria. Sarcopenia was assessed by nine muscle mass diagnostic criteria, by two muscle strength criteria and also by the combination of criteria. Prevalence was analyzed for each method, along with differences by gender and age group through calculation of the prevalence ratio (PR) and confidence interval (CI) 95%. The Kappa coefficient was used to analyze the level of agreement between all criteria. Sarcopenia prevalence varied between 60.6% and 8.3% with the application of muscle mass criteria, and between 54.2% and 48.8% with the application of strength criteria. The combination muscle mass+strength resulted in a decrease of prevalence in all criteria, varying between 36.6% and 6.1%. There was an increase in prevalence according to age groups for all methods. Prevalence was higher for men according to three muscle mass criteria, and higher in women for strength criteria and by two combined mass+strength criteria. The best level of agreement was obtained for two methods that utilized dual energy X-ray absorptiometry (DXA). The prevalence of sarcopenia differs by gender and age and definition criteria. The low agreement levels obtained between methods and the different prevalence values encountered indicate the necessities of an operational definition for the estimation of sarcopenia in different population.

摘要

本横断面研究纳入了132名社区居住的老年人(≥60岁),目的是利用不同的诊断标准确定巴西老年人肌少症的患病率,并分析各标准之间的一致性。通过九种肌肉量诊断标准、两种肌肉力量标准以及标准组合来评估肌少症。分析了每种方法的患病率,以及通过计算患病率比(PR)和95%置信区间(CI)得出的性别和年龄组差异。使用Kappa系数分析所有标准之间的一致性水平。应用肌肉量标准时,肌少症患病率在60.6%至8.3%之间;应用力量标准时,患病率在54.2%至48.8%之间。肌肉量+力量的组合在所有标准下均导致患病率下降,在36.6%至6.1%之间。所有方法的患病率均随年龄组增加。根据三种肌肉量标准,男性患病率较高;根据力量标准以及两种肌肉量+力量组合标准,女性患病率较高。利用双能X线吸收法(DXA)的两种方法一致性水平最佳。肌少症的患病率因性别、年龄和定义标准而异。各方法之间较低的一致性水平以及所遇到的不同患病率值表明,需要为不同人群中肌少症的评估制定一个可操作的定义。

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