Center for Primary Health Care Research, Lund University, Jan Waldenströms gata 35, 20502, Malmö, Sweden.
Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane, 693-8501, Japan.
Int J Health Geogr. 2020 Nov 25;19(1):51. doi: 10.1186/s12942-020-00247-9.
Sarcopenia, resulting from loss of muscle mass and function, is highly prevalent in the ageing societies and is associated with risk of falls, frailty, loss of independence, and mortality. It is important to identify environmental risk factors, so that evidence-based interventions to prevent sarcopenia can be implemented at the population level. This study aimed to examine the potential effect of several objectively measured neighborhood environmental factors on longitudinal change of muscle mass and function among older adults living in rural Japanese towns where the population is ageing.
This study was based on data from the Shimane CoHRE Study conducted by the Center for Community-based Healthcare Research and Education (CoHRE) at Shimane University in 3 rural towns in the Shimane Prefecture, Japan. Subjects older than 60 years, who participated in an annual health examination in 2016 and any follow-up years until 2019, i.e., 4 possible time points in total, were included (n = 2526). The skeletal muscle mass index (SMI) and grip strength were assessed objectively for each year as a measure of muscle mass and function, respectively. Neighborhood environmental factors, i.e., hilliness, bus stop density, intersection density, residential density, and distance to a community center were measured by geographic information systems (GIS). Linear mixed models were applied to examine the potential effect of each neighborhood environmental factor on the change of SMI and grip strength over time.
Males living far from community centers had a less pronounced decline in SMI compared to those living close to community centers. Females living in areas with higher residential density had a less pronounced decline in grip strength compared to those living in areas with lower residential density.
Neighborhood environmental factors had limited effects on change of SMI and grip strength among rural older adults within the 3 years follow up. Further long-term follow up studies are necessary by also taking into account other modifiable neighborhood environmental factors.
肌肉减少症是由于肌肉质量和功能丧失引起的，在老龄化社会中非常普遍，与跌倒、虚弱、丧失独立性和死亡率风险相关。识别环境风险因素很重要，以便在人群层面实施基于证据的预防肌肉减少症的干预措施。本研究旨在探讨几种客观测量的邻里环境因素对居住在日本农村城镇的老年人肌肉质量和功能的纵向变化的潜在影响，这些城镇的人口正在老龄化。
本研究基于岛根县社区保健与教育研究中心（CoHRE）在日本岛根县的 3 个农村城镇开展的岛根 CoHRE 研究的数据。研究对象为年龄在 60 岁以上、参加了 2016 年年度体检且在随后的任何一年（共 4 个时间点）参加体检的老年人，共 2526 人。每年通过身体成分分析仪客观评估骨骼肌指数（SMI）和握力，分别作为肌肉质量和功能的指标。邻里环境因素，包括丘陵地形、公交站密度、交叉口密度、居住密度和到社区中心的距离，通过地理信息系统（GIS）进行测量。线性混合模型用于检验每个邻里环境因素对 SMI 和握力随时间变化的潜在影响。
与居住在社区中心附近的男性相比，居住在社区中心较远的男性的 SMI 下降幅度较小。与居住在居住密度较低地区的女性相比，居住在居住密度较高地区的女性的握力下降幅度较小。
在 3 年的随访期间，邻里环境因素对农村老年人的 SMI 和握力变化的影响有限。需要进一步进行长期随访研究，同时考虑其他可改变的邻里环境因素。
