Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care, Maastricht University, Minderbroedersberg 4-6, 6211, LK, Maastricht, The Netherlands.
Adullam Stiftung, Mittlere Strasse 15, 4056, Basel, Switzerland.
BMC Geriatr. 2020 Aug 26;20(1):307. doi: 10.1186/s12877-020-01718-1.
The European Working Group on Sarcopenia in Older People has recently defined new criteria for identifying "(probable) sarcopenia" (EWGSOP2). However, the prevalence of probable sarcopenia, defined by these guidelines, has not been determined extensively, especially in the oldest old. This study aims to determine the prevalence of probable sarcopenia in older, community-living people and its association with strength-related determinants.
Handgrip strength and reported determinants (age, height, weight, osteoarthritis of hands, medications, fall history, physical activity, activities of daily living (ADL) and global cognitive function) were collected in a cross-sectional study of 219 community-living Swiss people (75 years and over). Probable sarcopenia was estimated based on cut-off values for handgrip strength as recommended by EWGSOP2. Spearman correlations, binary-regression analyses and contingency tables were used to explore relationships between variables.
The prevalence of probable sarcopenia in women (n = 137, age 84.1 ± 5.7 years) and men (n = 82, age 82.6 ± 5.2 years) was 26.3 and 28.0%, respectively. In women, probable sarcopenia correlated positively with age and falls (r range 0.332-0.195, p < .05), and negatively with weight, cognition, physical activity, using stairs regularly, participating in sports activities and ADL performance (r range = - 0.141 - -0.409, p < .05). The only significant predictor of probable sarcopenia at the multivariate level was ADL performance (Wald(1) = 5.51, p = .019). In men, probable sarcopenia was positively correlated with age (r = 0.33, p < .05) and negatively with physical activity, participation in sports and ADL performance (r range - 0.221 - - 0.353, p < .05). ADL performance and age (Wald(1) = 4.46, p = .035 and Wald(1) = 6.30, p = .012) were the only significant predictors at the multivariate level. Men and women with probable sarcopenia were 2.8 times more likely to be dependent in ADL than those without.
Probable sarcopenia affected one in every four community-living, oldest old people and was independently associated with impaired ADL performance in both sexes. This highlights the importance of detection of handgrip strength in this age group in clinical practice. Although prospective studies are required, independence in ADL might help to protect against probable sarcopenia.
欧洲老年人肌肉减少症工作组最近为识别“（可能）肌肉减少症”定义了新的标准（EWGSOP2）。然而，这些指南定义的可能的肌肉减少症的患病率尚未得到广泛确定，尤其是在最年长的老年人中。本研究旨在确定社区居住的老年人中可能的肌肉减少症的患病率及其与与力量相关的决定因素的关系。
在一项对 219 名居住在瑞士的社区老年人（年龄在 75 岁及以上）的横断面研究中，收集了握力和报告的决定因素（年龄、身高、体重、手部骨关节炎、药物、跌倒史、身体活动、日常生活活动（ADL）和整体认知功能）。根据 EWGSOP2 推荐的握力截断值估计可能的肌肉减少症。使用 Spearman 相关、二元回归分析和列联表来探索变量之间的关系。
女性（n=137，年龄 84.1±5.7 岁）和男性（n=82，年龄 82.6±5.2 岁）中可能的肌肉减少症的患病率分别为 26.3%和 28.0%。在女性中，可能的肌肉减少症与年龄和跌倒呈正相关（r 范围为 0.332-0.195，p<0.05），与体重、认知、身体活动、定期使用楼梯、参加体育活动和 ADL 表现呈负相关（r 范围为-0.141 到-0.409，p<0.05）。多变量水平上唯一显著的可能肌肉减少症预测因素是 ADL 表现（Wald(1)=5.51，p=0.019）。在男性中，可能的肌肉减少症与年龄呈正相关（r=0.33，p<0.05），与身体活动、参加体育活动和 ADL 表现呈负相关（r 范围为-0.221 到-0.353，p<0.05）。ADL 表现和年龄（Wald(1)=4.46，p=0.035 和 Wald(1)=6.30，p=0.012）是多变量水平上唯一显著的预测因素。与无可能肌肉减少症的男性和女性相比，可能有肌肉减少症的男性和女性在 ADL 方面依赖的可能性高出 2.8 倍。
在社区居住的最年长的老年人中，有四分之一的人可能患有肌肉减少症，并且无论性别如何，这种疾病都与 ADL 表现受损独立相关。这凸显了在临床实践中检测握力的重要性。尽管需要前瞻性研究，但 ADL 的独立性可能有助于预防可能的肌肉减少症。
