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FNIH 定义的肌肉减少症可预测台湾社区居住老年人的不良结局:来自宜兰纵向老龄化研究的结果。

FNIH-defined Sarcopenia Predicts Adverse Outcomes Among Community-Dwelling Older People in Taiwan: Results From I-Lan Longitudinal Aging Study.

机构信息

Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taiwan.

Aging and Health Research Center, Taipei, Taiwan.

出版信息

J Gerontol A Biol Sci Med Sci. 2018 May 9;73(6):828-834. doi: 10.1093/gerona/glx148.

Abstract

BACKGROUND

To evaluate the predictive validity of sarcopenia defined by the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project among Asian older adults.

METHODS

Data of the I-Lan Longitudinal Aging Study were obtained for analysis. Overall, 1,839 community-dwelling people aged 50 years and older, capable of completing a 6-m walk, with life expectancy of more than 6 months, and not institutionalized at time of data collection were enrolled for study. Data for subjects aged 65 years and older were obtained for study. The outcome measures were all-cause mortality and a composite adverse outcome which includes hospitalizations, emergency department visits, institutionalization, and falls.

RESULTS

Data of 728 eligible elderly participants (73.4 ± 5.4 years; 52.9% males) were analyzed. The prevalence of FNIH-diagnosed sarcopenia was 9.5%: 11.9% males; 6.7% females. Participants having FNIH-defined sarcopenia were considerably older, frailer, more obese, with poorer physical performance than nonsarcopenic subjects (All p < .001); during mean follow-up of 32.9 ± 8.8 months, they also had 3.8 times higher risk of dying, independent of age, sex, multimorbidity, cognitive function, and nutritional status (hazard ratio = 3.8; 95% confidence interval = 1.26-11.45; p = .018). Moreover, sarcopenia defined by grip strength-BMI ratio (WeakBMI) showed stronger association with composite adverse outcomes than traditional handgrip strength (hazard ratio = 1.99; 95% confidence interval = 1.01-3.93; p = .047 vs hazard ratio = 1.80; 95% confidence interval = 0.89-3.62; p = .102 in fully-adjusted model).

CONCLUSION

Among community-dwelling older people in Taiwan, participants with FNIH-defined sarcopenia had a significantly greater risk of all-cause mortality and composite falls, emergency department visits, institutionalization, and hospitalization.

摘要

背景

评估由美国国立卫生研究院(FNIH)肌少症计划定义的肌少症在亚洲老年人中的预测有效性。

方法

本研究分析了宜兰纵向老龄化研究的数据。总体而言,共纳入了 1839 名年龄在 50 岁及以上、能够完成 6 米步行、预期寿命超过 6 个月且在数据收集时未住院的社区居住者进行研究。对年龄在 65 岁及以上的受试者进行了研究。研究的结局指标包括全因死亡率和复合不良结局,包括住院、急诊就诊、住院和跌倒。

结果

共分析了 728 名符合条件的老年参与者(73.4±5.4 岁;52.9%为男性)的数据。FNIH 诊断的肌少症患病率为 9.5%:男性为 11.9%;女性为 6.7%。与非肌少症患者相比,患有 FNIH 定义的肌少症的患者年龄更大、身体更虚弱、更肥胖、身体表现更差(均 P<.001);在平均 32.9±8.8 个月的随访期间,他们的死亡风险也高出 3.8 倍,与年龄、性别、多病共存、认知功能和营养状况无关(风险比=3.8;95%置信区间=1.26-11.45;P=0.018)。此外,与传统握力相比,握力-体重指数(WeakBMI)定义的肌少症与复合不良结局的相关性更强(风险比=1.99;95%置信区间=1.01-3.93;P=0.047 与风险比=1.80;95%置信区间=0.89-3.62;P=0.102 在完全调整模型中)。

结论

在台湾的社区居住的老年人中,FNIH 定义的肌少症患者全因死亡率和复合跌倒、急诊就诊、住院和住院的风险显著增加。

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