Mori Hiroyasu, Tokuda Yasunobu
Institute of Advanced Medical Sciences, University of Tokushima, Tokushima, Japan.
Faculty of Health Science Department, Hyogo University, Hyogo, Japan.
Asia Pac J Clin Nutr. 2019;28(1):157-165. doi: 10.6133/apjcn.201903_28(1).0021.
Sarcopenia and frailty result in loss of function and independence. Sarcopenia may be a risk factor for frailty; however, risk factors for sarcopenia with frailty, and associated incidence of falls and poor quality of life remain unclear. We investigated the clinical characteristics and relevant factors for sarcopenia with frailty in older community-dwelling Japanese.
This cross-sectional study included 331 Japanese community-dwelling adults aged ≥60 years. We assessed falls history in the past year, health-related quality of life (HRQOL), including physical component summary (PCS) and mental component summary (MCS), age, total energy intake per ideal body weight (TEI/kg IBW), total protein intake/kg IBW, vitamin D intake, and exercise habits. Sarcopenia was determined using low hand grip strength or slow gait speed and low skeletal muscle mass index. Frailty was determined if ≥3 components, such as unintended weight loss, exhaustion, low muscle strength, slow gait speed, and low physical activity were present.
The prevalence of sarcopenia with frailty was 3.6%; such participants had a higher risk of recurrent falls and lower PCS and MCS scores than robust participants. Age, TEI/kg IBW, total protein intake/kg IBW, and vitamin D intake were significantly associated with risk of sarcopenia with frailty by multivariate logistic regression analysis.
This study showed that sarcopenia with frailty was had higher incidences of recurrent fall and poor HRQOL than robust older adults. Aging and poor energy, protein, and vitamin D intake, may be relevant factors for sarcopenia with frailty.
肌肉减少症和衰弱会导致功能丧失和生活不能自理。肌肉减少症可能是衰弱的一个风险因素；然而，伴有衰弱的肌肉减少症的风险因素以及相关的跌倒发生率和生活质量低下情况仍不明确。我们调查了日本社区居住老年人中伴有衰弱的肌肉减少症的临床特征及相关因素。
这项横断面研究纳入了331名年龄≥60岁的日本社区居住成年人。我们评估了过去一年的跌倒史、健康相关生活质量（HRQOL），包括身体成分总结（PCS）和心理成分总结（MCS）、年龄、按理想体重计算的每日总能量摄入量（TEI/kg IBW）、按千克理想体重计算的总蛋白质摄入量、维生素D摄入量以及运动习惯。肌肉减少症通过低握力或慢步速以及低骨骼肌质量指数来确定。如果存在≥3项指标，如非故意体重减轻、疲惫、肌肉力量低下、步速缓慢和身体活动量低，则判定为衰弱。
伴有衰弱的肌肉减少症的患病率为3.6%；与身体健壮的参与者相比，这类参与者反复跌倒的风险更高，PCS和MCS评分更低。通过多因素逻辑回归分析，年龄、TEI/kg IBW、按千克理想体重计算的总蛋白质摄入量和维生素D摄入量与伴有衰弱的肌肉减少症的风险显著相关。
本研究表明，与身体健壮的老年人相比，伴有衰弱的肌肉减少症患者反复跌倒的发生率更高，健康相关生活质量较差。衰老以及能量、蛋白质和维生素D摄入不足可能是伴有衰弱的肌肉减少症的相关因素。
