Bianchi Lara, Ferrucci Luigi, Cherubini Antonio, Maggio Marcello, Bandinelli Stefania, Savino Elisabetta, Brombo Gloria, Zuliani Giovanni, Guralnik Jack M, Landi Francesco, Volpato Stefano
Department of Medical Sciences, University of Ferrara, Italy.
Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, NIH, Baltimore, Maryland.
J Gerontol A Biol Sci Med Sci. 2016 Feb;71(2):259-64. doi: 10.1093/gerona/glv129. Epub 2015 Sep 2.
Sarcopenia is associated with increased risk of adverse outcomes in older people. Aim of the study was to explore the predictive value of the European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic algorithm in terms of disability, hospitalization, and mortality and analyze the specific role of grip strength and walking speed as diagnostic criteria for sarcopenia.
Longitudinal analysis of 538 participants enrolled in the InCHIANTI study. Sarcopenia was defined as having low muscle mass plus low grip strength or low gait speed (EWGSOP criteria). Muscle mass was assessed using bioimpedance analysis. Cox proportional and logistic regression models were used to assess risk of death, hospitalization, and disability for sarcopenic people and to investigate the individual contributions of grip strength and walking speed to the predictive value of the EWGSOP's algorithm.
Prevalence of EWGSOP-defined sarcopenia at baseline was 10.2%. After adjusting for potential confounders, sarcopenia was associated with disability (odds ratio 3.15; 95% confidence interval [CI] 1.41-7.05), hospitalization (hazard ratio [HR] 1.57; 95% CI 1.03-2.41), and mortality (HR 1.88; 95% CI 0.91-3.91). The association between an alternative sarcopenic phenotype, defined only by the presence of low muscle mass and low grip strength, and both disability and mortality were similar to the association with the phenotypes defined by low muscle mass and low walking speed or by the EWGSOP algorithm.
The EWGSOP's phenotype is a good predictor of incident disability, hospitalization and death. Assessment of only muscle weakness, in addition to low muscle mass, provided similar predictive value as compared to the original algorithm.
肌肉减少症与老年人不良结局风险增加相关。本研究的目的是探讨老年人肌肉减少症欧洲工作组(EWGSOP)诊断算法在残疾、住院和死亡率方面的预测价值,并分析握力和步行速度作为肌肉减少症诊断标准的具体作用。
对参加InCHIANTI研究的538名参与者进行纵向分析。肌肉减少症定义为肌肉量低加上握力低或步速低(EWGSOP标准)。使用生物电阻抗分析评估肌肉量。采用Cox比例和逻辑回归模型评估肌肉减少症患者的死亡、住院和残疾风险,并研究握力和步行速度对EWGSOP算法预测价值的个体贡献。
基线时EWGSOP定义的肌肉减少症患病率为10.2%。在调整潜在混杂因素后,肌肉减少症与残疾(优势比3.15;95%置信区间[CI]1.41 - 7.05)、住院(风险比[HR]1.57;95%CI 1.03 - 2.41)和死亡率(HR 1.88;95%CI 0.91 - 3.91)相关。仅由低肌肉量和低握力定义的另一种肌肉减少症表型与残疾和死亡率之间的关联,与由低肌肉量和低步行速度定义的表型或EWGSOP算法定义的表型之间的关联相似。
EWGSOP的表型是新发残疾、住院和死亡的良好预测指标。与原始算法相比,仅评估肌肉无力以及低肌肉量具有相似的预测价值。