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老年人握力参考值及其与内在能力领域的关系。

Reference values for handgrip strength and their association with intrinsic capacity domains among older adults.

机构信息

Centro de Estudios en Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, D.C., Colombia.

Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, USACH, Santiago, Chile.

出版信息

J Cachexia Sarcopenia Muscle. 2019 Apr;10(2):278-286. doi: 10.1002/jcsm.12373. Epub 2019 Mar 6.

Abstract

OBJECTIVE

The purposes of this study were three-fold: (i) to describe handgrip strength in older individuals aged ≥60 years in Colombia; (ii) to identify sex-specific and age-specific muscle weakness cut-off points in older adults; and (iii) to determine the odds of adverse events for each of the intrinsic capacity domains for individuals with handgrip strength greater than the muscle weakness cut-off points, as compared with their weaker counterparts.

METHODS

A cross-sectional study was conducted in Colombia, among 5237 older adults aged ≥60 years old (58.5% women, 70.5 ± 7.8 years), according to 'SABE Survey 2015'. Handgrip strength data were obtained with a Takei dynamometer. Sociodemographic variables, five domains of intrinsic capacity (i.e. locomotion, vitality, cognition, psychological, and sensory), and medical conditions were assessed and analyzed. Adjustments variables were age, ethnicity, socio-economic status, urbanicity, body mass index, smoking status, alcohol intake, drug use, physical activity, and co-morbid chronic diseases. Sex-stratified analyses were conducted with logistic regression models.

RESULTS

Handgrip strength was greater among men than among women (26.7 ± 8.5 vs. 16.7 ± 5.7 kg, respectively, P < 0.001) at all ages. Weak handgrip strength cut-off points ranged from 17.4 to 8.6 and from 10.1 to 4.9 in men and women, respectively. Overall, participants with optimal handgrip strength had better intrinsic capacity [in men, odds ratio (OR) = 0.62, 95% confidence interval (CI) 0.53 to 0.71; P < 0.001; and in women, OR = 0.79, 95% CI 0.68 to 0.92; P = 0.002] than their weaker counterparts. Also, men with optimal handgrip strength had a lower risk of hospitalization (OR = 0.47, 95% CI 0.29 to 0.78; P = 0.004) than their weaker counterparts.

CONCLUSIONS

This study is the first to describe handgrip strength values and cut-off points for muscle weakness among a nationally representative sample of Colombian older adults by age and sex. After categorizing older adults as weak or not weak based on the handgrip cut-off points, non-weakness was associated with a decreased odds of intrinsic capacity impairments. These cut-off points may be good candidates for clinical assessment of risks to physical and mental health in older Colombian adults.

摘要

目的

本研究旨在:(i)描述哥伦比亚≥60 岁老年人的握力;(ii)确定老年人中特定性别和年龄的肌肉无力截断点;(iii)确定握力大于肌肉无力截断点的个体在内在能力领域发生不良事件的几率与较弱个体相比。

方法

本横断面研究在哥伦比亚进行,共纳入 5237 名≥60 岁的老年人(女性占 58.5%,70.5±7.8 岁),依据“SABE 调查 2015 年”进行。握力数据使用泰科(Takei)测力计获得。评估和分析了社会人口统计学变量、内在能力的五个领域(即:运动能力、活力、认知、心理和感官)以及医疗状况。调整变量为年龄、种族、社会经济地位、城市状况、体重指数、吸烟状况、饮酒量、药物使用、身体活动和合并慢性疾病。对男性和女性进行了分层分析,采用 logistic 回归模型。

结果

在所有年龄段,男性的握力均大于女性(分别为 26.7±8.5kg 和 16.7±5.7kg,P<0.001)。男性和女性的弱握力截断点分别为 17.4-8.6kg 和 10.1-4.9kg。总体而言,握力最佳的参与者内在能力更好[男性,比值比(OR)=0.62,95%置信区间(CI)为 0.53-0.71;P<0.001;女性,OR=0.79,95%CI 为 0.68-0.92;P=0.002],而握力较弱的参与者内在能力较差。此外,握力最佳的男性住院风险较低(OR=0.47,95%CI 为 0.29-0.78;P=0.004),而握力较弱的男性住院风险较高。

结论

本研究首次描述了按年龄和性别划分的哥伦比亚全国代表性老年人样本的握力值和肌肉无力截断点。根据握力截断点将老年人分为弱或非弱后,非弱与内在能力受损的几率降低有关。这些截断点可能是评估哥伦比亚老年成年人身心健康风险的临床评估的良好候选者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf71/6463468/ae2c3e727c81/JCSM-10-278-g001.jpg

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