Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, 5180 Kurokawa, Imizu 939-0398, Japan.
Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan; Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
Maturitas. 2018 Jul;113:26-31. doi: 10.1016/j.maturitas.2018.03.007. Epub 2018 Mar 13.
Whether sarcopenia predicts incident homebound status remains unclear. This prospective cohort study aimed to determine the impact of sarcopenia on the incidence of homebound status in community-dwelling older adults.
The study included 3958 community-dwelling elderly people aged ≥65 years who were not homebound at baseline. Sarcopenia was defined as the presence of both poor muscle function (low physical performance or low muscle strength) and low muscle mass. Potential confounding factors, such as physical status, mental status, and level of social participation, were also assessed. Fifteen months after the baseline measurements, data regarding the incidence of homebound status were obtained using a postal survey.
In the 15-month follow-up survey, 83 participants (2.1%, 95% confidence interval = 1.6-2.5) were reported to have become homebound. A multiple logistic regression analysis indicated that age (odds ratio = 1.06, 95% confidence interval = 1.02-1.10), sarcopenia (1.98, 1.04-3.77), and limited contact with friends (1.82, 1.03-3.23) were independently associated with an increased risk of becoming homebound. In a stratified analysis for age group, a significant odds ratio for low level of social role (2.50, 1.06-5.91) was observed in young-old subjects (aged 65-74 years), whereas significant odds ratios for sarcopenia (2.80, 1.33-5.91) and physical inactivity (2.85, 1.28-6.37) were observed in old-old subjects (aged 75 years and over).
Sarcopenia had a strong impact on the risk of becoming homebound. Particularly in old-old subjects, sarcopenia and physical inactivity may impair people's ability to engage in activities outside the home much more than either their mental status or their level of social participation.
肌少症是否预示着即将出现居家状态尚不清楚。本前瞻性队列研究旨在确定肌少症对社区居住的老年人居家状态发生率的影响。
本研究纳入了 3958 名年龄≥65 岁且基线时无居家状态的社区居住老年人。肌少症定义为存在肌肉功能差（体力活动差或肌肉力量低）和低肌肉量。还评估了身体状况、精神状态和社会参与程度等潜在的混杂因素。在基线测量后 15 个月，通过邮寄调查获得有关居家状态发生率的数据。
在 15 个月的随访调查中，有 83 名参与者（2.1%，95%置信区间 1.6-2.5）报告出现居家状态。多因素逻辑回归分析表明，年龄（比值比 1.06，95%置信区间 1.02-1.10）、肌少症（1.98，1.04-3.77）和与朋友的联系有限（1.82，1.03-3.23）与居家状态的风险增加独立相关。在按年龄组分层分析中，在年轻老年人（65-74 岁）中，低社会角色水平（2.50，1.06-5.91）的比值比有显著意义，而在老老年人（75 岁及以上）中，肌少症（2.80，1.33-5.91）和身体不活动（2.85，1.28-6.37）的比值比有显著意义。
肌少症对居家状态的风险有很大影响。特别是在老老年人中，肌少症和身体不活动可能比精神状态或社会参与程度更能削弱人们参与户外活动的能力。
