Bahat Gulistan, Kilic Cihan, Altinkaynak Mustafa, Akif Karan Mehmet
Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
Aging Male. 2020 Dec;23(5):1564-1569. doi: 10.1080/13685538.2020.1870038. Epub 2021 Jan 12.
We aimed to compare European Working Group on Sarcopenia in Older People (EWGSOP2)-suggested and population-specific handgrip strength (HGS) thresholds to detect probable sarcopenia and their associations with physical-performance measures and frailty.
A retrospective cross-sectional observational-study included geriatrics outpatients applied to a university-hospital. HGS, timed up and go test (TUG), and usual gait speed (UGS) were assessed. Frailty was screened by FRAIL-scale.
A total of 1825 older adults were included (mean age, 74.5 + 7.0 years; 68.8% female). Prevalence of low-HGS were 12.2% by the EWGSOP2-recommended (27/16 kg) cut-offs and 37.5% by population-specific cut-offs (35/20 kg) (<.001). When low-HGS was defined by EWGSOP2 suggested cut-offs, low-HGS was associated with impaired UGS, (odds ratio [OR] = 3.8, 95% confidence interval [CI]: 2.0-6.9, <.001); impaired TUG, (OR = 4.6, 95% CI: 2.4-8.8, <.001); and frailty (OR = 20.9, 95% CI: 8.3-53.0, <.001). Similarly, low HGS determined by population-specific cut-off points was associated with impaired UGS (OR = 3.1, 95% CI: 2.1-6.9, <.001); impaired TUG (OR = 6.0, 95% CI: 3.0-11.8, <.001); and frailty (OR = 7.3, 95% CI: 4.1-13.0, <.001).
Application of EWGSOP2-recommended standard HGS-cut-offs showed successful application in-practice. However, use of standard HGS cut-offs may result in underdiagnosis of probable sarcopenia. Therefore, we suggest that, whenever available, use of population-specific cut-offs for HGS may be better for correctly identifying older adults at risk.
我们旨在比较欧洲老年人肌少症工作组（EWGSOP2）建议的和特定人群的握力（HGS）阈值，以检测可能的肌少症，及其与身体性能指标和衰弱的关联。
一项回顾性横断面观察研究纳入了就诊于一所大学医院的老年门诊患者。评估了握力、计时起立行走测试（TUG）和日常步速（UGS）。采用衰弱量表筛查衰弱情况。
共纳入1825名老年人（平均年龄74.5±7.0岁；68.8%为女性）。按照EWGSOP2推荐的切点（27/16千克），低握力的患病率为12.2%；按照特定人群切点（35/20千克），患病率为37.5%（P<0.001）。当按照EWGSOP2建议的切点定义低握力时，低握力与日常步速受损相关（比值比[OR]=3.8，95%置信区间[CI]：2.0-6.9，P<0.001）；计时起立行走测试受损（OR=4.6，95%CI：2.4-8.8，P<0.001）；以及衰弱（OR=20.9，95%CI：8.3-53.0，P<0.001）。同样，按照特定人群切点确定的低握力与日常步速受损相关（OR=3.1，95%CI：2.1-6.9，P<0.001）；计时起立行走测试受损（OR=6.0，95%CI：3.0-11.8，P<0.001）；以及衰弱（OR=7.3，95%CI：4.1-13.0，P<0.001）。
应用EWGSOP2推荐的标准握力切点在实践中显示出成功应用。然而，使用标准握力切点可能会导致可能的肌少症诊断不足。因此，我们建议，只要可行，使用特定人群的握力切点可能更有利于正确识别有风险的老年人。
