Bravo-José Patricia, Moreno Elena, Espert Minerva, Romeu María, Martínez Pilar, Navarro Concepción
Pharmacy Service, RPMD Burriana, Burriana, Castellón, Spain.
Center Management and Elderly Program Department, Generalitat Valenciana, Valencia, Spain.
Clin Nutr ESPEN. 2018 Oct;27:113-119. doi: 10.1016/j.clnesp.2018.05.008. Epub 2018 Jun 2.
BACKGROUND & AIMS: Sarcopenia is a syndrome characterised by a progressive and generalised loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life and death. The main aim of the present study was to establish the prevalence of sarcopenia using EWGSOP-defined criteria in institutionalised older adult patients in long-term care institutions. A secondary purpose was to identify the risk factors that develop Sarcopenia in this population.
A Multicentre cross-sectional study was conducted in 334 institutionalised older adult patients, where the prevalence of sarcopenia and its relation with certain risk factors were measured. Physical performance was measured by gait speed, muscle strength measured by a handheld dynamometer and skeletal muscle mass measured using bioimpedance analysis. Different variables were collected: body mass index (BMI), diseases documented in the clinical record, the numbers of falls, the level of activity and functional ability.
Two hundred eighty five individuals were included. According the EWGSOP algorithm and the cut-off points proposed by Masanes et al. for the Spanish population, 118 (41.4%) participants presented sarcopenia, of which 32 patients (27%) suffered from moderate sarcopenia, 78 patients (66%) were identified as severe sarcopenia patients and only 8 (7%) were classified as sarcopenic obesity. More female residents (96 females (81.4%) vs. 22 males (18.6%), p < 0.0001) tended to be sarcopenic. Patients diagnosed with sarcopenia tended to be more functionally impaired and had a more unfavourable BMI than those who were not sarcopenic (Barthel score 40.93 vs, 49.22, p = 0.0034 and BMI 23.57 vs, 27.61, p < 0.0001). Results from regression analysis indicated that those older than 85 years old (OR 2.495, 95% CI 1.401-4.441), the female gender, (OR 3.215, 95%CI 1.635-6.324) and whose BMI was lower than 22 (OR 5.973, 95% CI 2.932-12.165) appeared to be associated with sarcopenia, whereas the Barthel Index and other factors were not.
The present study suggests that sarcopenia is highly prevalent in patients living in long-term care institutions, especially in female patients. Our findings support that the muscle mass was negatively associated with poor nutritional status and poor capacity to develop basic activities of daily living that indicates high dependency of these patients and high necessity of care.
肌肉减少症是一种以骨骼肌质量和力量进行性、全身性丧失为特征的综合征，存在身体残疾、生活质量差和死亡等不良后果的风险。本研究的主要目的是使用欧洲老年人肌肉减少症工作组（EWGSOP）定义的标准，确定长期护理机构中机构化老年患者的肌肉减少症患病率。次要目的是确定该人群中发生肌肉减少症的风险因素。
对334名机构化老年患者进行了一项多中心横断面研究，测量了肌肉减少症的患病率及其与某些风险因素的关系。通过步速测量身体表现，用手持测力计测量肌肉力量，使用生物电阻抗分析测量骨骼肌质量。收集了不同变量：体重指数（BMI）、临床记录中记录的疾病、跌倒次数、活动水平和功能能力。
纳入了285名个体。根据EWGSOP算法和马萨内斯等人针对西班牙人群提出的切点，118名（41.4%）参与者存在肌肉减少症，其中32名患者（27%）患有中度肌肉减少症，78名患者（66%）被确定为重度肌肉减少症患者，只有8名（7%）被归类为肌肉减少性肥胖。女性居民更容易出现肌肉减少症（96名女性（81.4%）对22名男性（18.6%），p < 0.0001）。被诊断为肌肉减少症的患者往往功能受损更严重，且BMI比未患肌肉减少症的患者更不理想（Barthel评分40.93对49.22，p = 0.0034；BMI 23.57对27.61，p < 0.0001）。回归分析结果表明，85岁以上的人（比值比2.495，95%置信区间1.401 - 4.441）、女性（比值比3.215，95%置信区间1.635 - 6.324）以及BMI低于22的人（比值比5.973，95%置信区间2.932 - 12.165）似乎与肌肉减少症有关，而Barthel指数和其他因素则无关。
本研究表明，肌肉减少症在长期护理机构的患者中非常普遍，尤其是女性患者。我们的研究结果支持肌肉质量与营养状况差和进行日常生活基本活动的能力差呈负相关，这表明这些患者高度依赖他人且护理需求很高。
