Gadelha André Bonadias, Neri Silvia Gonçalves Ricci, Oliveira Ricardo Jacó de, Bottaro Martim, David Ana Cristina de, Vainshelboim Baruch, Lima Ricardo M
a Faculty of Physical Education , University of Brasília , Brasília , Distrito Federal , Brazil.
b Master of Cancer Care Program , School of Health Sciences, Saint Francis University , Loretto , PA , USA.
Exp Aging Res. 2018 May-Jun;44(3):258-269. doi: 10.1080/0361073X.2018.1449591. Epub 2018 Mar 20.
Background/Study context: Falls represent the leading cause of accidental deaths in the elderly. Sarcopenia is a geriatric syndrome defined as the loss of muscle mass and strength. However, the association between falls and sarcopenia is still unclear. Thus, the aim of the present study was to investigate the association between different stages of sarcopenia and postural balance, risk of falls, and fear of falling in community-dwelling older women.
A total of 196 women (68.6 ± 6.5 years) underwent body composition (Dual-energy X-ray Absorptiometry), muscle strength (isokinetic), and functional (Timed Up-and-Go) assessments. Sarcopenia was classified according to European Working Group on Sarcopenia in Older People. Center of pressure (CoP) sway, risk, and fear of falling were assessed through force platform, QuickScreen, and Falls Efficacy Scale, respectively. ANOVA models and chi-squared were used to compare groups.
Severe sarcopenic subjects presented higher risk of falling when compared to the other stages (p < 0.01). Regarding CoP sway, both mean speed and mediolateral range were significantly higher in severe sarcopenia when compared to both nonsarcopenia and presarcopenia (p < 0.05). Fear of falling was higher in all sarcopenia stages when compared to nonsarcopenic individuals (p < 0.05).
Sarcopenia negatively affects balance, and both risk and fear of falling in community-dwelling older women. Moreover, this study provides evidence that sarcopenia severity is further associated to reduced balance and imposes an even greater risk of falls in the elderly.
背景/研究背景：跌倒为老年人意外死亡的主要原因。肌肉减少症是一种老年综合征，定义为肌肉质量和力量的丧失。然而，跌倒与肌肉减少症之间的关联仍不明确。因此，本研究旨在调查社区居住老年女性中肌肉减少症不同阶段与姿势平衡、跌倒风险及跌倒恐惧之间的关联。
共有196名女性（68.6±6.5岁）接受了身体成分（双能X线吸收法）、肌肉力量（等速肌力测试）和功能（计时起立行走测试）评估。根据欧洲老年人肌肉减少症工作组的标准对肌肉减少症进行分类。分别通过测力平台、快速筛查和跌倒效能量表评估压力中心（CoP）摆动、跌倒风险和跌倒恐惧。采用方差分析模型和卡方检验对各组进行比较。
与其他阶段相比，严重肌肉减少症患者的跌倒风险更高（p<0.01）。关于CoP摆动，与非肌肉减少症和肌肉减少症前期相比，严重肌肉减少症患者的平均速度和内外侧范围均显著更高（p<0.05）。与非肌肉减少症个体相比，所有肌肉减少症阶段的跌倒恐惧均更高（p<0.05）。
肌肉减少症对社区居住老年女性的平衡、跌倒风险和跌倒恐惧产生负面影响。此外，本研究提供的证据表明，肌肉减少症的严重程度与平衡能力下降进一步相关，并给老年人带来更大的跌倒风险。
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