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评估老年人肌肉减少症风险:简易肌肉减少症风险评估(MSRA)问卷

Assessing the Risk of Sarcopenia in the Elderly: The Mini Sarcopenia Risk Assessment (MSRA) Questionnaire.

作者信息

Rossi A P, Micciolo R, Rubele S, Fantin F, Caliari C, Zoico E, Mazzali G, Ferrari E, Volpato S, Zamboni M

机构信息

Andrea P Rossi, M.D., Ph.D. Department of Medicine, Division of Geriatrics, University of Verona, Ospedale Maggiore, Piazzale Stefani 1, 37126 Verona, Italy, +39-45-8122537, +39-45-8122043 (fax), E-mail :

出版信息

J Nutr Health Aging. 2017;21(6):743-749. doi: 10.1007/s12603-017-0921-4.

Abstract

OBJECTIVES

to validate the MSRA questionnaire proposed as prescreening tool for sarcopenia, in a population of community-dwelling elderly subjects.

DESIGN

observational study.

SETTING

community dwelling elderly subjects.

PARTICIPANTS

274 community dwelling elderly subjects, 177 women and 97 men, aged 66-78 years.

MEASUREMENTS

Based on EWGSOP diagnostic criteria subjects were classified as sarcopenic and non-sarcopenic. The Mini Sarcopenia Risk Assessment (MSRA) questionnaire, is composed of seven questions and investigates anamnestic and nutritional characteristics related to risk of sarcopenia onset (age, protein and dairy products consumption, number of meals per day, physical activity level, number of hospitalizations and weight loss in the last year).

RESULTS

33.5% of the study population, were classified as sarcopenic. With the 7-item MSRA score, subjects with a score of 30 or less, had a 4-fold greater risk of being sarcopenic than subjects with a score higher than 30 (OR:4.20;95% CI:2.26-8.06); area under the ROC curve was 0.786 (95% CI:0.725-0.847). In a logistic regression, considering as dependent variable the probability of being sarcopenic, and as independent variables the 7 items of the questionnaire, two items (number of meals and milk and dairy products consumption) showed non-significant diagnostic power. A 5-item score was then derived and the area under the ROC curve was 0.789 (95% IC:0.728-0.851). Taking into account the cost of false positive and false negative costs and the prevalence of sarcopenia, the "optimal" threshold of the original MSRA score (based on 7 items) is 30, with a sensitivity of 0.804 and a specificity of 0.505, while the "optimal" threshold of the MSRA score based on 5 items, is 45, with a sensitivity of 0.804 and a specificity of 0.604.

CONCLUSION

this preliminary study shows that the MSRA questionnaire is predictive of sarcopenia and can be suggested as prescreening instrument to detect this condition. The use of a short form of the MSRA questionnaire improves the capacity to identify sarcopenic subjects.

摘要

目的

在社区居住的老年人群体中验证作为肌肉减少症预筛查工具的MSRA问卷。

设计

观察性研究。

地点

社区居住的老年受试者。

参与者

274名社区居住的老年受试者,177名女性和97名男性,年龄在66 - 78岁之间。

测量

根据欧洲老年人肌肉减少症工作组(EWGSOP)诊断标准,将受试者分为肌肉减少症患者和非肌肉减少症患者。迷你肌肉减少症风险评估(MSRA)问卷由七个问题组成,调查与肌肉减少症发病风险相关的既往史和营养特征(年龄、蛋白质和乳制品摄入量、每日进餐次数、身体活动水平、住院次数以及过去一年的体重减轻情况)。

结果

33.5%的研究人群被归类为肌肉减少症患者。对于7项MSRA评分,得分30分及以下的受试者患肌肉减少症的风险是得分高于30分的受试者的4倍(比值比:4.20;95%置信区间:2.26 - 8.06);ROC曲线下面积为0.786(95%置信区间:0.725 - 0.847)。在逻辑回归分析中,将肌肉减少症的患病概率作为因变量,问卷的7个项目作为自变量,其中两个项目(进餐次数以及牛奶和乳制品摄入量)显示出无显著诊断能力。随后得出一个5项评分,其ROC曲线下面积为0.789(95%置信区间:0.728 - 0.851)。考虑到假阳性和假阴性成本以及肌肉减少症的患病率,原始MSRA评分(基于7项)的“最佳”阈值为30,敏感性为0.804,特异性为0.505,而基于5项的MSRA评分的“最佳”阈值为45,敏感性为0.804,特异性为0.604。

结论

这项初步研究表明,MSRA问卷可预测肌肉减少症,可作为检测该病症的预筛查工具。使用MSRA问卷的简短形式可提高识别肌肉减少症患者的能力。

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