Reijnierse Esmee M, Trappenburg Marijke C, Blauw Gerard Jan, Verlaan Sjors, de van der Schueren Marian A E, Meskers Carel G M, Maier Andrea B
Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam, The Netherlands.
Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam, The Netherlands; Department of Internal Medicine, Amstelland Hospital, Amstelveen, The Netherlands.
J Am Med Dir Assoc. 2016 Apr 1;17(4):371.e7-12. doi: 10.1016/j.jamda.2016.01.013. Epub 2016 Feb 24.
This study aimed to explore the concordance between definitions of sarcopenia and frailty in a clinically relevant population of geriatric outpatients.
Data were retrieved from a cross-sectional study.
The study was performed in a geriatric outpatient clinic of a middle-sized teaching hospital.
The study included 299 geriatric outpatients (mean age 82.4, SD 7.1) who were consecutively referred to the outpatient clinic.
Prevalence rates and subsequent concordance evolving from 3 definitions of sarcopenia and 2 definitions of frailty were compared. Definitions of sarcopenia included the European Working Group on Sarcopenia in Older People (gait speed, handgrip strength, muscle mass), International Working Group on Sarcopenia (gait speed, muscle mass) and the definition by Janssen (muscle mass). Definitions of frailty included the Fried frailty phenotype (weight loss, exhaustion, physical inactivity, handgrip strength, walk time) and the definition of Rockwood (use of walking aid, activities of daily living, incontinence, and cognitive impairment).
Prevalence rates for sarcopenia varied between 17% and 22% and between 29% and 33% for frailty. There was little concordance in intraindividual prevalence rates of sarcopenia and frailty using different definitions. None of the outpatients was classified as having sarcopenia and frailty according to all applied definitions. Outpatients with sarcopenia were more likely to be frail than frail outpatients to be sarcopenic.
This study clearly indicates that sarcopenia and frailty are 2 separate conditions based on the current definitions. It is important to diagnose sarcopenia and frailty as separate entities, as each may require specific treatment.
本研究旨在探讨老年门诊患者这一临床相关人群中肌肉减少症和衰弱的定义之间的一致性。
数据取自一项横断面研究。
该研究在一家中型教学医院的老年门诊进行。
研究纳入了299名老年门诊患者(平均年龄82.4岁,标准差7.1岁),这些患者是连续转诊至门诊的。
比较了肌肉减少症的3种定义和衰弱的2种定义所产生的患病率及随后的一致性。肌肉减少症的定义包括欧洲老年人肌肉减少症工作组的定义(步速、握力、肌肉量)、国际肌肉减少症工作组的定义(步速、肌肉量)以及扬森的定义(肌肉量)。衰弱的定义包括弗里德衰弱表型(体重减轻、疲惫、身体活动不足、握力、步行时间)和罗克伍德的定义(使用助行器、日常生活活动能力、失禁和认知障碍)。
肌肉减少症的患病率在17%至22%之间,衰弱的患病率在29%至33%之间。使用不同定义时,个体内肌肉减少症和衰弱的患病率几乎没有一致性。根据所有应用的定义,没有门诊患者被归类为同时患有肌肉减少症和衰弱。患有肌肉减少症的门诊患者比衰弱门诊患者更有可能出现肌肉减少症。
本研究清楚地表明,根据当前定义,肌肉减少症和衰弱是两种不同的状况。将肌肉减少症和衰弱作为独立的实体进行诊断很重要,因为每种情况可能需要特定的治疗。