Merchant Reshma Aziz, Chan Yiong Huak, Hui Richard Jor Yeong, Lim Jia Yi, Kwek Sing Cheer, Seetharaman Santhosh K, Au Lydia Shu Yi, Morley John E
Division of Geriatric Medicine, Department of Medicine, National University Hospital, National University Health System, Singapore, Singapore.
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Front Med (Lausanne). 2021 Apr 16;8:660463. doi: 10.3389/fmed.2021.660463. eCollection 2021.
Sarcopenia is defined as a progressive age-related loss in muscle mass and strength affecting physical performance. It is associated with many negative outcomes including falls, disability, cognitive decline, and mortality. Protein enriched diet and resistance training have shown to improve muscle strength and function but there is limited evidence on impact of dual-task exercise in possible sarcopenia. To evaluate impact of community-based dual-task exercise on muscle strength and physical function in possible sarcopenia defined by either slow gait (SG) or poor handgrip strength (HGS). The secondary aims include effect on cognition, frailty, falls, social isolation, and perceived health. Community-dwelling older adults ≥60 years old were recruited from screening program intended to identify seniors at risk, and invited to participate in dual-task exercise program called HAPPY (Healthy Aging Promotion Program for You). One hundred and eleven participants with possible sarcopenia completed 3 months follow-up. Questionnaire was administered on demographics, frailty, sarcopenia, falls, perceived health, social network, functional, and cognitive status. Physical performance included assessment of HGS, gait speed, and Short Physical Performance Battery test (SPPB). The mean age of the Exercise group was 75.9 years old and 73.0% were women. The Exercise group had more female (73.0 vs. 47.5%), were older (75.9 vs. 72.5 years old), had higher prevalence of falls (32.4 vs. 15.0%), lower BMI (23.7 vs. 25.8), and education (4.0 vs. 7.2 years). The gait speed of the Exercise group increased significantly with significant reduction in the prevalence of SG and poor HGS. All components of SPPB as well as the total score increased significantly while the prevalence of pre-frailty and falls dropped by half. The risk of social isolation reduced by 25% with significant improvement in perceived health and cognition in the Exercise group. Significant impact on improvement gait speed and SPPB persisted after adjustment for baseline factors. Dual-task exercise program is effective in improving gait speed, SPPB score, and reducing the prevalence of poor HGS with significant improvement in perceived health, cognition, and reduction in falls and frailty. Future prospective randomized control trials are needed to evaluate the effectiveness of dual-task interventions in reversing sarcopenia.
肌肉减少症被定义为与年龄相关的、影响身体机能的肌肉质量和力量的渐进性丧失。它与许多负面结果相关，包括跌倒、残疾、认知能力下降和死亡率。富含蛋白质的饮食和抗阻训练已被证明可改善肌肉力量和功能，但关于双重任务训练对可能患有肌肉减少症的影响的证据有限。为了评估基于社区的双重任务训练对由步态缓慢（SG）或握力差（HGS）定义的可能患有肌肉减少症的老年人的肌肉力量和身体功能的影响。次要目标包括对认知、虚弱、跌倒、社会隔离和健康感知的影响。从旨在识别有风险老年人的筛查项目中招募了年龄≥60岁的社区居住老年人，并邀请他们参加一个名为HAPPY（健康老龄化促进计划）的双重任务训练项目。111名可能患有肌肉减少症的参与者完成了3个月的随访。对人口统计学、虚弱、肌肉减少症、跌倒、健康感知、社交网络、功能和认知状态进行了问卷调查。身体机能评估包括HGS、步速和简短身体机能测试（SPPB）。运动组的平均年龄为75.9岁，73.0%为女性。运动组女性更多（73.0%对47.5%），年龄更大（75.9岁对72.5岁），跌倒发生率更高（32.4%对15.0%），体重指数更低（23.7对25.8），受教育程度更低（4.0年对7.2年）。运动组的步速显著增加，SG和HGS差的发生率显著降低。SPPB的所有组成部分以及总分均显著增加，而虚弱前期和跌倒的发生率下降了一半。运动组的社会隔离风险降低了25%，健康感知和认知能力有显著改善。在对基线因素进行调整后，对步速和SPPB改善的显著影响依然存在。双重任务训练项目在提高步速、SPPB评分以及降低HGS差的发生率方面有效，同时在健康感知、认知方面有显著改善，跌倒和虚弱情况减少。未来需要进行前瞻性随机对照试验来评估双重任务干预在逆转肌肉减少症方面的有效性。
