Bianchi Lara, Abete Pasquale, Bellelli Giuseppe, Bo Mario, Cherubini Antonio, Corica Francesco, Di Bari Mauro, Maggio Marcello, Manca Giovanna Maria, Rizzo Maria Rosaria, Rossi Andrea P, Landi Francesco, Volpato Stefano
Department of Medical Science, University of Ferrara, Ferrara, Italy.
Department of Translational Medical Sciences, University of Naples Federico II, Italy.
J Gerontol A Biol Sci Med Sci. 2017 Oct 12;72(11):1575-1581. doi: 10.1093/gerona/glw343.
Prevalence of sarcopenia is substantial in most geriatrics settings, but estimates vary greatly across studies because of difference in population characteristics, diagnostic criteria, and methods used to assess muscle mass, muscle strength, and physical performance. We investigated the feasibility of the European Working Group on Sarcopenia in Older People (EWGSOP) algorithm assessment in hospitalized older adults and analyzed prevalence and clinical correlates of sarcopenia.
Cross-sectional analysis of 655 participants enrolled in a multicenter observational study of older adults admitted to 12 acute hospital wards in Italy. Sarcopenia was assessed as low skeletal mass index (kg/m2) plus either low handgrip strength or low walking speed (EWGSOP criteria). Skeletal muscle mass was estimated using bioimpedance analysis.
Of the 655 patients (age 81.0 ± 6.8 years; women 51.9%) enrolled in the study, 275 (40.2%) were not able to perform the 4-m walking test because of medical problems. The overall prevalence of sarcopenia on hospital admission was 34.7% (95% confidence interval 28-37) and it steeply increased with aging (p < .001). In multivariable analysis, patients with sarcopenia on hospital admission were older and were more likely to be male and to have congestive heart failure, cerebrovascular disease, and severe basic activities of daily living disability. The prevalence of sarcopenia was inversely correlated with body mass index.
Based on EWGSOP criteria, prevalence of sarcopenia is extremely high among older adults on admission to acute hospital wards. Older age, male gender, congestive heart failure, cerebrovascular disease, severe activities of daily living disability, and body mass index were the clinical variables significantly associated with the presence of sarcopenia.
在大多数老年病学环境中，肌肉减少症的患病率很高，但由于人群特征、诊断标准以及评估肌肉质量、肌肉力量和身体机能的方法存在差异，不同研究的估计值差异很大。我们调查了老年人肌肉减少症欧洲工作组（EWGSOP）算法评估在住院老年人中的可行性，并分析了肌肉减少症的患病率及其临床相关因素。
对参与意大利12个急性医院病房收治的老年人多中心观察性研究的655名参与者进行横断面分析。肌肉减少症被评估为低骨骼肌质量指数（kg/m²）加上低握力或低步行速度（EWGSOP标准）。使用生物电阻抗分析估算骨骼肌质量。
在该研究纳入的655例患者（年龄81.0±6.8岁；女性占51.9%）中，275例（40.2%）因医疗问题无法进行4米步行测试。入院时肌肉减少症的总体患病率为34.7%（95%置信区间28 - 37），且随年龄增长急剧上升（p <.001）。在多变量分析中，入院时患有肌肉减少症的患者年龄更大，更可能为男性，且更易患充血性心力衰竭、脑血管疾病以及严重的日常生活活动障碍。肌肉减少症的患病率与体重指数呈负相关。
基于EWGSOP标准，急性医院病房入院的老年人中肌肉减少症的患病率极高。年龄较大、男性、充血性心力衰竭、脑血管疾病、严重的日常生活活动障碍以及体重指数是与肌肉减少症存在显著相关的临床变量。
