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老年多病患者的身体活动、肌肉力量与多重用药情况:KORA-Age研究结果

Physical activity, muscular strength, and polypharmacy among older multimorbid persons: Results from the KORA-Age study.

作者信息

Volaklis K A, Thorand B, Peters A, Halle M, Heier M, Strasser B, Amann U, Ladwig K H, Schulz H, Koenig W, Meisinger C

机构信息

Department of Prevention and Sports Medicine, Technische Universitaet Muenchen, Munich, Germany.

7FIT Cardiac Rehabilitation Center, Augsburg, Germany.

出版信息

Scand J Med Sci Sports. 2018 Feb;28(2):604-612. doi: 10.1111/sms.12884. Epub 2017 Apr 12.

DOI:10.1111/sms.12884
PMID:28329413
Abstract

The purpose of this study was to examine whether physical activity (PA) and muscular strength (MS) are related to polypharmacy. Our cross-sectional analysis was based on 711 patients with multimorbidity (MMB), aged 65-94 years, who participated in the KORA-Age study. Participants underwent a face-to-face interview and extensive physical examinations including anthropometric measurements, registration of chronic diseases, determination of health-related behaviors (smoking, alcohol intake, physical activity, etc.), collection of blood samples and measurement of hand-grip strength. PPha was defined as the use of >4 drugs and MMB as having ≥2 of 13 chronic diseases. Prevalence of PPha was 44.6% (n=317), and a significant difference was found in the number of drugs used between participants with and without PPha (7.2±2.1 vs 2.5±1.2, P<.001). Patients in the lower compared to the upper tertile of physical activity had a significantly increased odds to be on PPha (OR: 1.64, 95% CI: 1.05-2.56, P=.031) after controlling for age, gender, BMI, family status, education, alcohol intake, smoking habits, number of diseases, hs-CRP, and telomere length. On the contrary, no significant association between muscular strength and PPha was found (OR: 1.04, 95% CI: 0.66-1.63, P=.873) after multivariable adjustment. Among older persons with MMB, lower levels of physical activity, but not low muscular strength, are associated with higher odds of PPha. Increasing the levels of physical activity appears to be highly recommended in order to potentially reduce the risk of PPha among multimorbid persons aged 65 and older.

摘要

本研究的目的是检验体力活动(PA)和肌肉力量(MS)是否与多重用药有关。我们的横断面分析基于711名65 - 94岁患有多种慢性病(MMB)的患者,他们参与了KORA - Age研究。参与者接受了面对面访谈和全面的体格检查,包括人体测量、慢性病登记、健康相关行为(吸烟、饮酒、体力活动等)的测定、血样采集以及握力测量。多重用药被定义为使用超过4种药物,多种慢性病被定义为患有13种慢性病中的至少2种。多重用药的患病率为44.6%(n = 317),在有和没有多重用药的参与者之间使用的药物数量存在显著差异(7.2±2.1对2.5±1.2,P <.001)。在控制了年龄、性别、体重指数、家庭状况、教育程度、饮酒、吸烟习惯、疾病数量、超敏C反应蛋白和端粒长度后,体力活动处于较低三分位数的患者相比处于较高三分位数的患者,使用多重用药的几率显著增加(比值比:1.64,95%置信区间:1.05 - 2.56,P =.031)。相反,在多变量调整后,未发现肌肉力量与多重用药之间存在显著关联(比值比:1.04,95%置信区间:0.66 - 1.63,P =.873)。在患有多种慢性病的老年人中,较低水平的体力活动而非低肌肉力量与多重用药的较高几率相关。为了潜在地降低65岁及以上患有多种疾病的人群中多重用药的风险,强烈建议增加体力活动水平。

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