National Health and Medical Research Council (NHMRC), Centre of Research Excellence: Frailty and Healthy Ageing, University of Adelaide, South Australia, Australia.
National Health and Medical Research Council (NHMRC), Centre of Research Excellence: Frailty and Healthy Ageing, University of Adelaide, South Australia, Australia; Adelaide Geriatrics Training & Research with Aged Care (G-TRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, South Australia, Australia; Aged and Extended Care Services, Central Adelaide Local Health Network, South Australia, Australia.
Maturitas. 2021 Feb;144:102-107. doi: 10.1016/j.maturitas.2020.11.009. Epub 2020 Dec 1.
Frailty and sarcopenia are age-related conditions with shared features and are both associated with adverse health outcomes. Relatively little is known about outcomes of these conditions in combination. The aim of this study was to examine the predictive ability of combined frailty and sarcopenia classification on mortality.
Frailty was measured in 716 community-dwelling adults aged ≥65 years from the North West Adelaide Health Study (mean age 74.1(6.1) years, 55.5 % female) using the frailty phenotype (FP) and sarcopenia using the revised consensus definition from the European Working Group on Sarcopenia. Participants were classified as: neither frail nor sarcopenic, frail-only, sarcopenic-only, or both frail and sarcopenic. All participants had a minimum of 10 years of mortality follow-up.
We identified 2.8 % of participants as both frail and sarcopenic, 15.5 % as frail-only, and 3.5 % as sarcopenic-only. Classification as both frail and sarcopenic, in a multivariable model, resulted in significantly elevated mortality risk (HR = 3.52, p < .001), which was over three times that of those neither frail nor sarcopenic. Frail-only was also a significant mortality predictor (HR = 2.03, p = .001), while classification as sarcopenic-only was not a significant predictor of mortality (HR = 1.65, p = .141). There was no significant difference in severity of frailty (mean number of characteristics) or grip strength between frail-only and those with both conditions when stratified by sex.
Individuals identified as frail would benefit from screening and assessment for sarcopenia, and vice versa for those identified as sarcopenic, as the mortality risk for individuals with these conditions in combination is nearly double that of each separately.
衰弱和肌少症是与年龄相关的两种病症，具有共同特征，且均与不良健康结局相关。对于这两种病症同时存在的结果，我们知之甚少。本研究旨在探讨衰弱和肌少症联合分类对死亡率的预测能力。
采用衰弱表型（FP）测量 716 名年龄≥65 岁的社区居住成年人（平均年龄 74.1(6.1)岁，55.5%为女性）的衰弱情况，使用欧洲肌少症工作组修订共识定义测量肌少症。参与者分为：非衰弱且非肌少症、衰弱但非肌少症、肌少症但非衰弱、衰弱且肌少症。所有参与者的死亡率随访时间均不少于 10 年。
我们发现，2.8%的参与者同时存在衰弱和肌少症，15.5%为衰弱但非肌少症，3.5%为肌少症但非衰弱。在多变量模型中，同时存在衰弱和肌少症的分类显著增加了死亡风险（HR=3.52，p<0.001），这一风险是既非衰弱也非肌少症的三倍多。仅衰弱也是显著的死亡预测指标（HR=2.03，p=0.001），而仅肌少症不是死亡率的显著预测指标（HR=1.65，p=0.141）。当按性别分层时，仅衰弱与同时存在两种病症的患者在衰弱严重程度（特征数量平均值）或握力方面没有显著差异。
对于被诊断为衰弱的个体，筛查和评估肌少症将获益，反之亦然，因为同时存在这两种病症的个体的死亡率风险几乎是每种病症单独存在时的两倍。
