Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Sci Rep. 2017 Aug 21;7(1):8418. doi: 10.1038/s41598-017-08791-4.
The impact of dynapenia on the complexity of care for residents of long-term care facilities (LTCF) remains unclear. The present study evaluated associations between dynapenia, care problems and care complexity in 504 residents of Veterans Care Homes (VCHs) in Taiwan. Subjects with dynapenia, defined as low muscle strength (handgrip strength <26 kg), were older adults with lower body mass index (BMI), slow gait speed, and higher numbers of Resident Assessment Protocol (RAP) triggers. After adjusting for age, education, BMI, and Charlson's comorbidity index (CCI), only age, education, BMI and gait speed were independently associated with higher numbers of RAP triggers, but not dynapenia or handgrip strength (kg). Dividing subjects into groups based on quartiles of gait speed, those with gait speed ≤0.803 m/s were significantly associated with higher complexity of care needs (defined as ≥4 RAP triggers) compared to the reference group (gait speed >1 m/s). Significantly slow gait speed was associated with RAP triggers, including cognitive loss, poor communication ability, rehabilitation needs, urinary incontinence, depressed mood, falls, pressure ulcers, and use of psychotropic drugs. In conclusion, slow gait speed rather than dynapenia is a simple indicator for higher complexity of care needs of older male LTCF residents.
力量衰减对长期护理机构（LTCF）居民护理复杂性的影响尚不清楚。本研究评估了台湾 504 名退伍军人护理院（VCH）居民的力量衰减、护理问题和护理复杂性之间的关系。力量衰减定义为肌肉力量低（握力<26kg），其特征为老年人、较低的身体质量指数（BMI）、较慢的步态速度和更高的居民评估计划（RAP）触发因素数量。在调整年龄、教育程度、BMI 和 Charlson 合并症指数（CCI）后，只有年龄、教育程度、BMI 和步态速度与更高的 RAP 触发因素独立相关，而与力量衰减或握力（kg）无关。根据步态速度的四分位数将受试者分组，与参考组（步态速度>1m/s）相比，步态速度≤0.803m/s 的受试者明显与更高的护理需求复杂性（定义为≥4 RAP 触发因素）相关。显著较慢的步态速度与 RAP 触发因素相关，包括认知能力下降、沟通能力差、康复需求、尿失禁、情绪低落、跌倒、压疮和使用精神药物。总之，与力量衰减相比，较慢的步态速度是男性 LTCF 居民更高护理需求复杂性的简单指标。
