Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore.
Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
J Gerontol A Biol Sci Med Sci. 2020 Jun 18;75(7):1379-1385. doi: 10.1093/gerona/glaa076.
Sarcopenia is often conceptualized as a precursor to loss of mobility, but its effect on recovery of mobility after a hip fracture is unknown. We determined the prevalence of low muscle strength (weakness) after hip fracture using putative sarcopenia metrics (absolute grip strength, and grip strength normalized to body mass index, total body fat, arm lean mass, and weight) identified by the Sarcopenia Definitions and Outcomes Consortium (SDOC).
We examined two well-characterized hip fracture cohorts of community-dwelling older adults from the Baltimore Hip Studies (BHS). The prevalence of muscle weakness was assessed using the SDOC cut points compared to published definitions at 2 and 6 months postfracture. We assessed associations of 2-month weakness with 6-month walking speed <0.6 m/s and calculated the sensitivity and specificity in predicting lack of meaningful change in walking speed (change < 0.1 m/s) at 6 months.
Two hundred and forty-six participants (192 women; 54 men) were included; mean (SD) age of 81 (8) for women and 78 (7) for men. At 2 months, 91% women and 78% men exhibited slow walking speed (< 0.6 m/s). SDOC grip strength standardized by weight (<0.34 kg women, <0.45 kg men) was the most prevalent measure of weakness in men (74%) and women (79%) and provided high sensitivity in men (86%) and women (84%) predicting lack of meaningful change in walking speed at 6 months, although specificity was poor to moderate.
SDOC cut points for grip strength standardized to weight provided consistent indication of poor walking speed performance post-hip fracture.
肌肉减少症通常被认为是丧失活动能力的前兆，但它对髋部骨折后恢复活动能力的影响尚不清楚。我们使用肌肉减少症定义和结果联盟（SDOC）确定的假设性肌肉减少症指标（绝对握力以及握力与体重指数、总体脂肪、手臂瘦体重和体重的比值）来确定髋部骨折后低肌肉力量（虚弱）的患病率。
我们检查了来自巴尔的摩髋部研究（BHS）的两个具有良好特征的社区居住的老年髋部骨折队列。使用 SDOC 切点与骨折后 2 和 6 个月的已发表定义相比，评估肌肉虚弱的患病率。我们评估了 2 个月时的虚弱与 6 个月时行走速度<0.6m/s 的相关性，并计算了在 6 个月时预测行走速度无明显变化（变化<0.1m/s）的灵敏度和特异性。
共纳入 246 名参与者（192 名女性；54 名男性）；女性平均（SD）年龄为 81（8）岁，男性为 78（7）岁。在 2 个月时，91%的女性和 78%的男性行走速度较慢（<0.6m/s）。按体重标准化的 SDOC 握力（<0.34kg 女性，<0.45kg 男性）是男性（74%）和女性（79%）最常见的虚弱测量指标，在男性（86%）和女性（84%）中具有较高的灵敏度预测 6 个月时行走速度无明显变化，但特异性较差至中等。
按体重标准化的握力 SDOC 切点一致表明髋部骨折后行走速度表现不佳。
