中国老年养老院居民中肌少症的流行率：四种诊断标准的比较。
The Prevalence of Sarcopenia in Chinese Elderly Nursing Home Residents: A Comparison of 4 Diagnostic Criteria.
机构信息
Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, Sichuan, China; School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China.
出版信息
J Am Med Dir Assoc. 2018 Aug;19(8):690-695. doi: 10.1016/j.jamda.2018.04.015. Epub 2018 Jun 8.
OBJECTIVES
To investigate the prevalence and associated factors of sarcopenia defined by different criteria in nursing home residents.
DESIGN
A cross-sectional study.
SETTING
Four nursing homes in Chengdu, China.
PARTICIPANTS
Elderly adults aged 65 years or older.
MEASUREMENTS
We applied 4 diagnostic criteria [European Working Group on Sarcopenia in Older People (EWGSOP), Asia Working Group for Sarcopenia (AWGS), International Working Group on Sarcopenia (IWGS), and Foundation for the National Institutes of Health (FNIH)] to define sarcopenia. Muscle mass, strength, and function were measured based on bioimpedance analysis, handgrip strength, and walking speed, respectively. Nutrition status, activities of daily living, calf circumference (CC), and other covariates were evaluated.
RESULTS
We included 277 participants. The prevalence of sarcopenia was 32.5%, 34.3%, 38.3%, and 31.4% according to the EWGSOP, AWGS, IWGS, and FNIH criteria, respectively. Fifty-eight participants (20.9%) were sarcopenic by all the 4 criteria. Regardless of the diagnostic criteria of sarcopenia, malnutrition was independently associated with sarcopenia [EWGSOP: odds ratio (OR) 4.02, 95% confidence interval (CI) 1.05-15.39; IWGS: OR 2.46, 95% CI 1.23-4.90; AWGS: OR 3.29, 95% CI 1.49-7.28; FNIH: OR 4.52, 95% CI 1.28-16.00], whereas CC was negatively associated with sarcopenia [EWGSOP: OR per standard deviation (SD) 0.32, 95% CI 0.20-0.52; IWGS: OR per SD 0.26, 95% CI 0.15-0.43; AWGS: OR per SD 0.32, 95% CI 0.19-0.52; FNIH: OR per SD 0.39, 95% CI 0.25-0.60]. Furthermore, falls ≥1 time in the past year were associated with AWGS-defined sarcopenia (OR 2.92, 95% CI 1.04-8.22).
CONCLUSION/IMPLICATIONS: Sarcopenia is highly prevalent in elderly Chinese nursing home residents regardless of the diagnostic criteria. Malnutrition and CC are associated with sarcopenia defined by different criteria. Therefore, it is important to assess sarcopenia and malnutrition in the management of nursing home residents. Prospective studies addressing the outcomes of sarcopenia in nursing home residents are warranted.
目的
调查不同标准定义的养老院居民肌少症的流行率及其相关因素。
设计
横断面研究。
地点
中国成都的 4 家养老院。
参与者
年龄在 65 岁及以上的老年人。
测量方法
我们应用了 4 种诊断标准[欧洲老年人肌少症工作组（EWGSOP）、亚洲肌少症工作组（AWGS）、国际肌少症工作组（IWGS）和美国国立卫生研究院基金会（FNIH）]来定义肌少症。肌肉质量、力量和功能分别通过生物阻抗分析、手握力和步行速度来测量。评估了营养状况、日常生活活动、小腿围（CC）和其他协变量。
结果
我们纳入了 277 名参与者。根据 EWGSOP、AWGS、IWGS 和 FNIH 标准，肌少症的患病率分别为 32.5%、34.3%、38.3%和 31.4%。58 名参与者（20.9%）符合所有 4 种标准的肌少症。无论肌少症的诊断标准如何，营养不良均与肌少症独立相关[EWGSOP：比值比（OR）4.02，95%置信区间（CI）1.05-15.39；IWGS：OR 2.46，95%CI 1.23-4.90；AWGS：OR 3.29，95%CI 1.49-7.28；FNIH：OR 4.52，95%CI 1.28-16.00]，而 CC 与肌少症呈负相关[EWGSOP：每标准差（SD）的 OR 0.32，95%CI 0.20-0.52；IWGS：每 SD 的 OR 0.26，95%CI 0.15-0.43；AWGS：每 SD 的 OR 0.32，95%CI 0.19-0.52；FNIH：每 SD 的 OR 0.39，95%CI 0.25-0.60]。此外，过去 1 年中跌倒≥1 次与 AWGS 定义的肌少症相关（OR 2.92，95%CI 1.04-8.22）。
结论/意义：无论诊断标准如何，中国养老院的老年居民肌少症的患病率均较高。营养不良和 CC 与不同标准定义的肌少症相关。因此，评估肌少症和营养不良对于养老院居民的管理非常重要。需要进行前瞻性研究来探讨养老院居民肌少症的结局。
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