School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Level 5 / Block E, 246 Clayton Road, Clayton, VIC, 3168, Australia.
School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia.
Osteoporos Int. 2019 Oct;30(10):1911-1922. doi: 10.1007/s00198-019-05080-w. Epub 2019 Jul 19.
Maintaining mobility is an important aspect of health and well-being in older men. This literature review describes several modifiable and nonmodifiable risk factors impacting bone, muscle, and joint health. Exercise and nutritional interventions may help to prevent the progressive deterioration in bones, muscles, and joints impacting mobility in later life. Limitations in mobility are increasingly recognized as a major public health problem due to an aging population and growing number of older individuals affected by disabling comorbidities. Despite increasing numbers and debilitating consequences, there are no guidelines providing recommendations on strategies to maintain mobility for healthy aging among older men. This narrative review aims to fill this literature gap. PubMed, Scopus, and Google Scholar databases were searched using predefined search terms. Primary studies, exploratory analyses, cross-sectional surveys, meta-analyses, evidence-based clinical reviews, and guidelines from nationally recognized societies focusing on mobility in older men and key elements including bone, muscle and joint health, and balance were selected. Several modifiable and nonmodifiable risk factors have been reported in the literature that impact bone, muscle, and joint health and predispose older men to falls and fractures. The most common conditions impacting bones, muscles, and joints are osteoporosis, sarcopenia, and osteoarthritis, respectively. In addition to being key contributors to disability in the elderly, these conditions are all associated with a higher mortality risk. Although more studies are required, current evidence supports the use of various nonpharmacological (mainly exercise and nutrition) and/or pharmacological treatment modalities to help prevent and/or reverse these conditions. Incorporating lifestyle interventions involving exercise and nutrition at a younger age can help prevent the age-related, progressive deterioration in bones, muscles, and joints that can reduce mobility in later life. Established barriers to physical activities (e.g., poor health, social isolation) in men are important to consider for optimizing outcomes.
保持活动能力是老年男性健康和幸福的一个重要方面。本文综述描述了一些可改变和不可改变的风险因素，这些因素影响骨骼、肌肉和关节的健康。运动和营养干预可能有助于预防骨骼、肌肉和关节的逐渐恶化，从而影响晚年的活动能力。由于人口老龄化和越来越多的患有致残性合并症的老年人，活动能力受限越来越被认为是一个主要的公共卫生问题。尽管人数不断增加，后果严重，但没有指南提供关于保持健康老年男性活动能力的策略建议。本叙述性综述旨在填补这一文献空白。使用预定义的搜索词在 PubMed、Scopus 和 Google Scholar 数据库中进行了搜索。选择了主要研究、探索性分析、横断面调查、荟萃分析、基于证据的临床综述以及关注老年男性活动能力和关键要素（包括骨骼、肌肉和关节健康以及平衡）的国家认可学会的指南。文献中报道了一些可改变和不可改变的风险因素，这些因素影响骨骼、肌肉和关节的健康，并使老年男性易患跌倒和骨折。影响骨骼、肌肉和关节最常见的疾病分别是骨质疏松症、肌肉减少症和骨关节炎。除了是老年人残疾的主要原因外，这些疾病都与更高的死亡率风险相关。尽管还需要更多的研究，但目前的证据支持使用各种非药物治疗（主要是运动和营养）和/或药物治疗方法来帮助预防和/或逆转这些疾病。在年轻时就开始进行涉及运动和营养的生活方式干预，可以帮助预防与年龄相关的骨骼、肌肉和关节的逐渐恶化，从而降低晚年的活动能力。对于优化结果，需要考虑男性存在的一些身体活动障碍（例如，健康状况不佳、社会孤立）。
