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社区居住的老年人中，肌肉质量和力量低与 10 年内健康相关的生活质量的前瞻性关联。

Prospective associations of low muscle mass and strength with health-related quality of life over 10-year in community-dwelling older adults.

机构信息

Menzies Institute for Medical Research, University of Tasmania, Australia.

Menzies Institute for Medical Research, University of Tasmania, Australia; Faculty of Health, University of Tasmania, Australia.

出版信息

Exp Gerontol. 2019 Apr;118:65-71. doi: 10.1016/j.exger.2019.01.008. Epub 2019 Jan 12.

DOI:10.1016/j.exger.2019.01.008

PMID:30641106

Abstract

AIMS

This study aims to describe the associations of low muscle mass, handgrip (HGS) and lower-limb muscle strength (LMS) with health-related quality of life (HRQoL) over 10 years in community-dwelling older adults.

METHODS

Participants (N = 1002; 51% women; mean age 63 ± 7.4 years) were prospectively followed for 10 years. HRQoL was measured using the validated assessment of quality of life (AQoL) instrument. Appendicular lean mass (ALM) was assessed using dual energy X-ray absorptiometry and normalized to body mass index (BMI). HGS and LMS were assessed using dynamometers. Low ALM/BMI (ALM/BMI), LMS (LMS) and HGS (HGS) at baseline were defined as the lowest 20% of the sex-specific distribution for each measure. Linear mixed effect regression models, adjusting for confounders, were used to estimate the association between ALM/BMI, LMS, and HGS at baseline and HRQoL over 10 years.

RESULTS

Participants with LMS (β = -0.061, 95% CI: -0.089, -0.033) and women (β = -0.089, 95% CI: -0.129, -0.049) but not men (β = -0.023, 95% CI: -0.064, 0.019) with HGS had clinically meaningful reductions in HRQoL over 10 years compared to those with normal strength. There was a weaker but statistically significant association between ALM/BMI and 10-year HRQoL (β = -0.038, 95% CI: -0.068, -0.008).

CONCLUSIONS

Lower-limb muscle strength and handgrip strength (in women only), which can be easily measured in clinical practice, appear more important than muscle mass for HRQoL.

摘要

目的

本研究旨在描述肌肉质量低、握力（HGS）和下肢肌肉力量（LMS）与社区居住的老年人 10 年内健康相关生活质量（HRQoL）之间的关联。

方法

参与者（N=1002；51%为女性；平均年龄 63±7.4 岁）前瞻性随访 10 年。使用经过验证的生活质量评估（AQoL）工具测量 HRQoL。使用双能 X 射线吸收法评估四肢瘦体重（ALM），并将其标准化为体重指数（BMI）。使用测力计评估 HGS 和 LMS。基线时低 ALM/BMI（ALM/BMI）、LMS（LMS）和 HGS（HGS）定义为每种测量的男女特定分布最低的 20%。使用线性混合效应回归模型，调整混杂因素，估计基线时 ALM/BMI、LMS 和 HGS 与 10 年内 HRQoL 之间的关联。

结果

与具有正常力量的参与者相比，LMS（β=-0.061，95%CI：-0.089，-0.033）和女性（β=-0.089，95%CI：-0.129，-0.049）但不是男性（β=-0.023，95%CI：-0.064，0.019）具有 LMS 的参与者以及基线时具有 HGS 的女性（β=-0.089，95%CI：-0.129，-0.049）具有临床意义的 HRQoL 降低。ALM/BMI 与 10 年 HRQoL 之间存在较弱但具有统计学意义的关联（β=-0.038，95%CI：-0.068，-0.008）。