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.
Exp Gerontol. 2019 Apr;118:65-71. doi: 10.1016/j.exger.2019.01.008. Epub 2019 Jan 12.
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.
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.
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).
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.
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。
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。
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）。
下肢肌肉力量和握力（仅在女性中），这些在临床实践中易于测量，似乎比肌肉质量对 HRQoL 更重要。
