Jung Hee-Won, Kim Sun-Wook, Lim Jae-Young, Kim Ki-Woong, Jang Hak Chul, Kim Cheol-Ho, Kim Kwang-il
Department of Internal Medicine, Seoul National University, Bundang Hospital, Seongnam, Korea; College of Medicine, College of Natural Sciences, Seoul National University, Seoul, Korea.
J Am Geriatr Soc. 2014 Nov;62(11):2110-7. doi: 10.1111/jgs.13107. Epub 2014 Nov 4.
To assess whether frailty is a risk factor for skeletal muscle mass decline in community-dwelling elderly people.
Prospective observational cohort study.
Seongnam, Gyeongi Province, Korea.
Community-dwelling Koreans aged 65 and older (n = 341).
Bioimpedance analysis (BIA) was used to measure body composition at baseline and 5 years later. Laboratory examination and comprehensive geriatric assessment were performed at both times. Lean mass index (LMI) was defined as total body lean mass/height(2). A decrease of more than 5% in the LMI was considered to be significant. Frailty status was defined using the Cardiovascular Health Study criteria.
LMI decline occurred in 196 (54.1%) subjects during the follow-up period (5.0 ± 0.7 years). Baseline LMI was highest in robust (17.6 ± 1.8 kg/m(2), n = 126), lower prefrail (17.0 ± 1.7 kg/m(2), n = 185), and lowest in frail (16.7 ± 1.3 kg/m(2), n = 30) subjects (P < .001). Frailty status was associated with LMI decline at 5-year follow-up (robust 0.81 ± 0.78 kg/m(2), prefrail 1.00 ± 0.92 kg/m(2), frail 1.35 ± 0.85 kg/m(2), P < .001). This effect of frailty on LMI decline persisted after adjusting for covariables (P = .02). The risk of significant LMI decline was 2.9 times as great in frail elderly adults as in those who were robust even after adjusting for covariates (95% confidence interval = 1.01-8.55).
Frailty status was found to be independently associated with subsequent LMI decline in community-dwelling older adults.
评估衰弱是否为社区居住老年人骨骼肌量下降的危险因素。
前瞻性观察队列研究。
韩国京畿道城南市。
65岁及以上的社区居住韩国人（n = 341）。
采用生物电阻抗分析（BIA）在基线和5年后测量身体成分。两次均进行实验室检查和综合老年评估。瘦体重指数（LMI）定义为全身瘦体重/身高²。LMI下降超过5%被认为具有显著性。采用心血管健康研究标准定义衰弱状态。
随访期间（5.0±0.7年），196名（54.1%）受试者出现LMI下降。在健康者中基线LMI最高（17.6±1.8kg/m²，n = 126），衰弱前期者较低（17.0±1.7kg/m²，n = 185），衰弱者最低（16.7±1.3kg/m²，n = 30）（P <.001）。在5年随访时，衰弱状态与LMI下降相关（健康者0.81±0.78kg/m²，衰弱前期者1.00±0.92kg/m²，衰弱者1.35±0.85kg/m²，P <.001）。调整协变量后，衰弱对LMI下降的这种影响仍然存在（P = 0.02）。即使调整协变量后，衰弱老年人出现显著LMI下降的风险也是健康老年人的2.9倍（95%置信区间 = 1.01 - 8.55）。
研究发现，在社区居住的老年人中，衰弱状态与随后的LMI下降独立相关。
