Cheng Ryan, Maloney Aidan, Moran Jay, Newman Thomas H, Gardner Elizabeth C
Yale University School of Medicine, Department of Orthopaedic Surgery and Rehabilitation, New Haven, CT, USA.
Yale College, Yale University, New Haven, CT, USA.
Clin Ther. 2022 Jan;44(1):33-40. doi: 10.1016/j.clinthera.2021.11.012. Epub 2021 Dec 12.
Sarcopenia or muscle mass atrophy reportedly occurs in up to 50% of those aged >80 years and is a significant risk factor for functional disability and poor physical performance. Over time, the deterioration in both skeletal muscle quality and composition may compromise functional independence and has been shown to independently increase the risk for falls, fractures, and overall poor health in the elderly population. These are seen most obviously in older women. Given these serious consequences, much effort has been directed toward promoting increased activity and resistance training for muscle maintenance or even muscle regeneration in older adults. The Centers for Disease Control and Prevention states that for all adults ≥65 years of age, weekly aerobic and strength training are vital to healthy aging. Older patients who have not previously participated in strength training may be hesitant about starting a resistance training program and resort to simple and familiar aerobic exercise options such as walking, jogging, or cycling. However, the benefits of strength training are too important to miss: it can improve skeletal muscle metabolic capacity, mitigate effects of aging on functional capacity, maintain bone density, and, most importantly, help individuals maintain a higher quality of life and independence. Due to their increased risk of disability and injury, this opportunity for "exercise as medicine" is particularly important to women and must be encouraged by clinicians. As such, the purpose of this commentary was to highlight known sex-related differences in muscle metabolism and potential benefits of resistance training for elderly patients. A comprehensive understanding of the issues and prevention measures presented here may allow clinicians to better serve their patients, especially older female patients, and, ultimately, alleviate the burden placed on our society by our rapidly aging population.
据报道,肌肉减少症或肌肉质量萎缩在80岁以上人群中发生率高达50%,是导致功能残疾和身体机能不佳的重要风险因素。随着时间的推移,骨骼肌质量和组成的恶化可能会损害功能独立性,并已被证明会独立增加老年人群跌倒、骨折和整体健康状况不佳的风险。这些情况在老年女性中最为明显。鉴于这些严重后果,人们已付出诸多努力,致力于促进老年人增加活动量以及进行抗阻训练,以维持肌肉甚至实现肌肉再生。疾病控制与预防中心指出,对于所有65岁及以上的成年人而言,每周进行有氧运动和力量训练对健康老龄化至关重要。以前未参加过力量训练的老年患者可能会对开始抗阻训练项目犹豫不决,而选择步行、慢跑或骑自行车等简单且熟悉的有氧运动方式。然而,力量训练的益处不容忽视:它可以提高骨骼肌代谢能力,减轻衰老对功能能力的影响,维持骨密度,最重要的是,帮助个体维持更高的生活质量和独立性。由于女性残疾和受伤风险增加,这种“运动即良药”的机会对她们尤为重要,临床医生必须予以鼓励。因此,本评论的目的是强调已知的肌肉代谢方面的性别差异以及抗阻训练对老年患者的潜在益处。全面了解此处提出的问题和预防措施,可能会使临床医生更好地为患者服务,尤其是老年女性患者,并最终减轻快速老龄化人口给社会带来的负担。