养老院居民肌少症的患病率及相关因素：系统评价和荟萃分析。
Prevalence and Associated Factors of Sarcopenia in Nursing Home Residents: A Systematic Review and Meta-analysis.
机构信息
Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China; The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
出版信息
J Am Med Dir Assoc. 2019 Jan;20(1):5-13. doi: 10.1016/j.jamda.2018.09.012. Epub 2018 Nov 5.
OBJECTIVE
To review the prevalence and associated factors of sarcopenia in nursing homes.
DESIGN
A systematic review and meta-analysis of published studies in MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials.
SETTING
Nursing homes.
PARTICIPANTS
Older adults aged ≥60 years.
MEASUREMENTS
Sarcopenia was defined according to various validated diagnostic criteria, such as the European Working Group on Sarcopenia in Older People (EWGSOP) criteria and skeletal muscle index (SMI). We performed meta-analyses with random effects models to calculate the pooled prevalence of sarcopenia. The risk of bias of the included studies was evaluated using a 10-item tool explicitly designed for prevalence studies.
RESULTS
We included 16 studies with a total of 3585 participants from 129 nursing homes. The included studies were of low to moderate risk of bias. The pooled prevalences of EWGSOP-defined sarcopenia and SMI-defined sarcopenia were 41% [95% confidence interval (CI) 32%-51%, 12 studies, 2685 cases] and 59% (95% CI 24%-93%, 3 studies, 643 cases), respectively. The pooled prevalences of EWGSOP-defined sarcopenia in women and men were 46% (8 studies, 1332 cases) and 43% (8 studies, 739 cases), respectively. The pooled data showed that malnutrition was an independent associated factor of EWGSOP-defined sarcopenia (odds ratio [OR] 1.74, 95% CI 1.36-2.24; 3 studies, 718 cases), but malnutrition risk (OR 1.01, 95% CI 0.53-1.94; 2 studies, 379 cases) and female gender were not (OR 1.14, 95% CI 0.11-11.66; 3 studies, 827 cases). The association between age and body mass index with sarcopenia was inconsistent across studies. Limited evidence indicated that smoking might be related to sarcopenia.
CONCLUSIONS/IMPLICATIONS: Sarcopenia is highly prevalent in older nursing home residents. Malnutrition may be an associated factor of sarcopenia. More prospective studies are needed to clarify the association between age, gender, malnutrition, and smoking with sarcopenia.
目的
综述养老院中肌少症的流行情况及其相关因素。
设计
对 MEDLINE、EMBASE 和 Cochrane 对照试验中心注册库中已发表的研究进行系统评价和荟萃分析。
设置
养老院。
参与者
年龄≥60 岁的老年人。
测量方法
根据各种经过验证的诊断标准定义肌少症，如欧洲老年人肌少症工作组（EWGSOP）标准和骨骼肌指数（SMI）。我们采用随机效应模型进行荟萃分析，以计算肌少症的总患病率。使用专门为患病率研究设计的 10 项工具评估纳入研究的偏倚风险。
结果
我们纳入了 16 项研究，共纳入了来自 129 家养老院的 3585 名参与者。纳入的研究存在低到中度偏倚风险。根据 EWGSOP 定义的肌少症和 SMI 定义的肌少症的总患病率分别为 41%（95%置信区间 32%-51%，12 项研究，2685 例）和 59%（95%置信区间 24%-93%，3 项研究，643 例）。女性和男性中根据 EWGSOP 定义的肌少症的总患病率分别为 46%（8 项研究，1332 例）和 43%（8 项研究，739 例）。汇总数据显示，营养不良是 EWGSOP 定义的肌少症的一个独立相关因素（比值比[OR]1.74，95%置信区间 1.36-2.24；3 项研究，718 例），但营养不良风险（OR 1.01，95%置信区间 0.53-1.94；2 项研究，379 例）和女性性别不是（OR 1.14，95%置信区间 0.11-11.66；3 项研究，827 例）。年龄和体重指数与肌少症之间的关联在不同研究中并不一致。有限的证据表明，吸烟可能与肌少症有关。
结论/意义：养老院中老年人肌少症的患病率较高。营养不良可能是肌少症的一个相关因素。需要更多的前瞻性研究来阐明年龄、性别、营养不良和吸烟与肌少症之间的关系。
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