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遗忘型轻度认知障碍或阿尔茨海默病老年患者肌肉减少症的患病率及相关因素

Prevalence and associated factors of sarcopenia in elderly subjects with amnestic mild cognitive impairment or Alzheimer disease.

作者信息

Sugimoto Taiki, Ono Rei, Murata Shunsuke, Saji Naoki, Matsui Yasumoto, Niida Shumpei, Toba Kenji, Sakurai Takashi

机构信息

Kobe University, Graduate School of Health Sciences, Department of Community Health Sciences, 7- 10-2 Tomogaoka, Suma, Kobe, Hyogo, Japan 654-0142.

出版信息

Curr Alzheimer Res. 2016;13(6):718-26. doi: 10.2174/1567205013666160211124828.

Abstract

BACKGROUND

To date, very little is known about the nature of sarcopenia in subjects with cognitive impairment. The aims of this study were firstly to clarify the prevalence of sarcopenia at various stages of cognitive impairment, and secondly to examine factors related to sarcopenia in men and women with cognitive impairment.

METHOD

The subjects were 418 outpatients (normal cognition; NC: 35, amnestic mild cognitive impairment; aMCI: 40, Alzheimer disease; AD: 343) who attended the Memory Clinic at the National Center for Geriatrics and Gerontology of Japan during the period from October 2010 to July 2014. Cognitive status, vitality, depressive mood, body mass index, hand grip strength, timed up and go test, skeletal muscle mass and serum levels of 25-hydroxyvitamin D, albumin and creatinine were assessed. Sarcopenia was defined as the presence of both poor muscle function (low physical performance or low muscle strength) and low muscle mass. We performed the univariate and multivariate logistic regression analyses to explore factors associated with sarcopenia.

RESULTS

The overall prevalence of sarcopenia was 21.1% (NC = 8.6%, aMCI = 12.5%, AD = 23.3%). In both sexes, factors associated with sarcopenia were age (P < .01), body mass index (P < .001) and vitality (P < .05). In women, serum level of 25-hydroxyvitamin D was associated with sarcopenia (P < .05).

CONCLUSION

Low vitality could be a dementia-specific risk factor for sarcopenia. Prevention of sarcopenia in patients with cognitive impairment should be approached from physical and psychologic points of view.

摘要

背景

迄今为止,对于认知障碍患者中肌肉减少症的本质了解甚少。本研究的目的,一是明确认知障碍各阶段肌肉减少症的患病率,二是研究认知障碍男性和女性中与肌肉减少症相关的因素。

方法

研究对象为2010年10月至2014年7月期间在日本国立老年医学和老年学中心记忆门诊就诊的418名门诊患者(正常认知;NC:35例,遗忘型轻度认知障碍;aMCI:40例,阿尔茨海默病;AD:343例)。评估了认知状态、活力、抑郁情绪、体重指数、握力、计时起立行走测试、骨骼肌质量以及25-羟维生素D、白蛋白和肌酐的血清水平。肌肉减少症的定义为同时存在肌肉功能差(身体表现差或肌肉力量低)和肌肉量低。我们进行了单因素和多因素逻辑回归分析,以探索与肌肉减少症相关的因素。

结果

肌肉减少症的总体患病率为21.1%(NC = 8.6%,aMCI = 12.5%,AD = 23.3%)。在男女两性中,与肌肉减少症相关的因素有年龄(P <.01)、体重指数(P <.001)和活力(P <.05)。在女性中,25-羟维生素D的血清水平与肌肉减少症相关(P <.05)。

结论

活力低可能是痴呆症特有的肌肉减少症危险因素。应从身体和心理角度对认知障碍患者的肌肉减少症进行预防。

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