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在一家老年人跌倒与骨折诊所中,肌无力和肌少症作为残疾的危险因素

Dynapenia and Sarcopenia as a Risk Factor for Disability in a Falls and Fractures Clinic in Older Persons.

作者信息

Benjumea Angela-María, Curcio Carmen-Lucía, Duque Gustavo, Gómez Fernando

机构信息

Research Group on Geriatrics and Gerontology, Faculty of Health Sciences, International Association of Gerontology and Geriatrics Collaborative Centre, University of Caldas, Manizales, Colombia.

Australian Institute for Musculoskeletal Science (AIMSS), Melbourne Medical School - Western Precinct, The University Of Melbourne & Western Health, Melbourne, Australia.

出版信息

Open Access Maced J Med Sci. 2018 Feb 14;6(2):344-349. doi: 10.3889/oamjms.2018.087. eCollection 2018 Feb 15.

Abstract

BACKGROUND

The role of sarcopenia and dynapenia in disability in older persons from falls and bone health clinics remain unknown.

AIM

This study aims to compare the association of sarcopenia and dynapenia with physical and instrumental disability in a population of older persons attending a falls and fractures clinic.

METHODS

This is a cross-sectional study in Manizales, Andes Mountains, Colombia. A cohort of 534 subjects (mean age = 74, 75% female) Sarcopenia was measured according to the European Working Group on Sarcopenia in Older People (EWGSOP) including an index of skeletal mass, muscle strength, and gait speed. Dynapenia was defined as a handgrip force ≤ 30 kg for men and ≤ 20 kg for women.

RESULTS

Dynapenia and sarcopenia were present in 84.6% and 71.2% respectively. Both were more prevalent in older subjects and women than men. While sarcopenia was associated with body mass index and hypertension, dynapenia was associated with hypothyroidism and visual impairment. After controlling for all covariates, sarcopenia was associated with low IADL and mobility disability.

CONCLUSIONS

Sarcopenia was associated with mobility, ADL and IADL disability. Dynapenia was not associated with disability in this high - risk population. Systematic assessment of sarcopenia should be implemented in falls and fractures clinics to identify sarcopenia and develop interventions to prevent functional decline among elderly individuals.

摘要

背景

肌肉减少症和肌肉功能减退在跌倒与骨骼健康门诊的老年人残疾中的作用尚不清楚。

目的

本研究旨在比较肌肉减少症和肌肉功能减退与在跌倒与骨折门诊就诊的老年人群体中身体和工具性残疾之间的关联。

方法

这是一项在哥伦比亚安第斯山脉马尼萨莱斯进行的横断面研究。对534名受试者(平均年龄 = 74岁,75%为女性)进行队列研究。根据老年人肌肉减少症欧洲工作组(EWGSOP)的标准测量肌肉减少症,包括骨骼质量、肌肉力量和步态速度指标。肌肉功能减退定义为男性握力≤30千克,女性握力≤20千克。

结果

肌肉功能减退和肌肉减少症的发生率分别为84.6%和71.2%。二者在老年受试者和女性中比男性更为普遍。虽然肌肉减少症与体重指数和高血压有关,但肌肉功能减退与甲状腺功能减退和视力障碍有关。在控制所有协变量后,肌肉减少症与低工具性日常生活活动能力和行动障碍有关。

结论

肌肉减少症与行动、日常生活活动能力和工具性日常生活活动能力残疾有关。在这个高危人群中,肌肉功能减退与残疾无关。应在跌倒与骨折门诊对肌肉减少症进行系统评估,以识别肌肉减少症并制定干预措施,预防老年个体的功能衰退。

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