《亚洲肌少症工作组 2019 年更新版筛查和诊断工具在韩国社区居住 70 岁及以上老年人中的应用：肌少症》

Sarcopenia in Korean Community-Dwelling Adults Aged 70 Years and Older: Application of Screening and Diagnostic Tools From the Asian Working Group for Sarcopenia 2019 Update.

机构信息

Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Republic of Korea.

Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.

出版信息

J Am Med Dir Assoc. 2020 Jun;21(6):752-758. doi: 10.1016/j.jamda.2020.03.018. Epub 2020 May 5.

DOI:10.1016/j.jamda.2020.03.018

PMID:32386844

Abstract

OBJECTIVE

To describe the prevalence of sarcopenia in a large group of community-dwelling older adults using the Asian Working Group for Sarcopenia (AWGS) 2019 definition and algorithm.

DESIGN

Cross-sectional data analysis of a cohort study.

SETTING

The Nationwide Korean Frailty and Aging Cohort Study (KFACS).

PARTICIPANTS

A total of 2123 ambulatory community-dwelling older adults, aged 70 to 84 years (mean, 75.9 ± 3.9 years; 49.5% women) were enrolled in the KFACS.

METHODS

Appendicular skeletal muscle mass was measured by dual-energy x-ray absorptiometry. Physical function was assessed by handgrip strength, usual gait speed, the 5-times-sit-to-stand test, the timed up-and-go test, and the Short Physical Performance Battery. In a case-finding assessment, screening for sarcopenia was performed using the calf circumference (CC), SARC-F questionnaire, and SARC-F combined with CC (SARC-CalF).

RESULTS

According to the AWGS 2019 algorithm, 43.5%, 7.5%, and 26.0% of the subjects in the whole study sample were classified as those at risk for sarcopenia according to CC, SARC-F, and SARC-CalF, respectively. The prevalence rates of possible sarcopenia using 3 screening tools for case-finding and muscle strength or physical performance tests according to the AWGS 2019 diagnostic algorithm were 20.1% in men and 29.2% in women. The prevalence rates of sarcopenia, when defined as low muscle mass plus low handgrip strength and/or slow gait speed, were significantly higher according to the AWGS 2019 (21.3% in men and 13.8% in women) than the AWGS 2014 (10.3% in men and 8.1% in women) definitions. The prevalence of severe sarcopenia was 6.4% in men and 3.2% in women.

CONCLUSIONS/IMPLICATIONS: The results of our study suggest that the use of CC and SARC-CalF to screen for possible sarcopenia may be more suited than using the SARC-F questionnaire alone according to the AWGS 2019 diagnostic algorithm in community-dwelling adults aged 70 to 84 years. The prevalence of sarcopenia was significantly higher according to the AWGS 2019 than AWGS 2014 criteria.

摘要

目的

使用亚洲肌肉减少症工作组（AWGS） 2019 定义和算法，描述大量社区居住的老年人中肌少症的流行情况。

设计

队列研究的横断面数据分析。

地点

全国韩国虚弱和衰老队列研究（KFACS）。

参与者

共纳入 2123 名 70 至 84 岁（平均年龄 75.9 ± 3.9 岁；49.5%为女性）的社区活动老年人。

方法

通过双能 X 射线吸收法测量四肢骨骼肌质量。通过握力、常规步行速度、5 次坐站测试、计时起立行走测试和简易体能状况量表评估身体功能。在病例发现评估中，使用小腿围（CC）、SARC-F 问卷和 SARC-F 联合 CC（SARC-CalF）筛查肌少症。

结果

根据 AWGS 2019 算法，整个研究样本中，根据 CC、SARC-F 和 SARC-CalF，分别有 43.5%、7.5%和 26.0%的受试者被归类为有肌少症风险。使用 3 种病例发现筛查工具和根据 AWGS 2019 诊断算法的肌肉力量或身体表现测试，可能肌少症的患病率在男性中为 20.1%，在女性中为 29.2%。根据 AWGS 2019（男性 21.3%，女性 13.8%）定义，低肌肉量加低握力和/或慢步行速度的肌少症患病率明显高于 AWGS 2014（男性 10.3%，女性 8.1%）定义。严重肌少症的患病率为男性 6.4%，女性 3.2%。

结论/意义：本研究结果表明，根据 AWGS 2019 诊断算法，与单独使用 SARC-F 问卷相比，使用 CC 和 SARC-CalF 筛查可能的肌少症可能更适合 70 至 84 岁社区居住的成年人。根据 AWGS 2019，肌少症的患病率明显高于 AWGS 2014 标准。