Division of Physical Therapy, Doctoral Program in Health Sciences, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Tochigi, Japan.
Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan.
Geriatr Gerontol Int. 2023 May;23(5):371-375. doi: 10.1111/ggi.14583. Epub 2023 Apr 11.
Decreased gait speed in older adults has been associated with incident disability, cognitive impairment, institutionalization, falls, deterioration in level of care, and mortality. Gait speed has been reported to be related to leg asymmetry. However, the relationship between gait speed and leg skeletal muscle mass asymmetry in older adults requiring long-term care has not been clarified. In this study, we examined the association between gait speed and leg skeletal muscle mass asymmetry and the cutoff values of leg skeletal muscle mass asymmetry that may affect gait speed.
The asymmetry index of leg skeletal muscle mass was measured in 230 older adults under the Japanese long-term care insurance system using bioelectrical impedance analysis. This cross-sectional study used multiple regression analysis and receiver operating characteristic (ROC) curve analysis to determine the relationship between gait speed and the asymmetry index of leg skeletal muscle mass.
Multiple regression analysis revealed that the asymmetry index of leg skeletal muscle mass (β = -0.19, P = 0.002, R = 0.261) was independently and significantly associated with gait speed. Furthermore, ROC analysis showed that the cutoff value of the asymmetry index of leg skeletal muscle mass that identified reduced gait speed (<1.0 m/s) was 3.02% (Area under the curve = 0.62, sensitivity 47.3%, specificity 81.0%, P = 0.014).
The asymmetry index of leg skeletal muscle mass was associated with gait speed in older adults requiring long-term care. Future assessment and interventions directed towards symmetry of leg skeletal muscle mass may help to improve gait speed in older adults. Geriatr Gerontol Int 2023; 23: 371-375.
老年人步速减慢与残疾、认知障碍、住院、跌倒、护理水平下降和死亡有关。已经有研究报道，步速与腿部不对称有关。然而，在需要长期护理的老年人中，步速与腿部骨骼肌质量不对称之间的关系尚未阐明。在这项研究中，我们研究了步速与腿部骨骼肌质量不对称之间的关系，以及可能影响步速的腿部骨骼肌质量不对称的截止值。
本横断面研究使用生物电阻抗分析法测量了 230 名符合日本长期护理保险制度的老年人腿部骨骼肌质量的不对称指数。采用多元回归分析和受试者工作特征（ROC）曲线分析来确定步速与腿部骨骼肌质量不对称指数之间的关系。
多元回归分析显示，腿部骨骼肌质量不对称指数（β=-0.19，P=0.002，R²=0.261）与步速独立且显著相关。此外，ROC 分析显示，腿部骨骼肌质量不对称指数的截止值可识别出步速降低（<1.0 m/s），为 3.02%（曲线下面积=0.62，敏感性 47.3%，特异性 81.0%，P=0.014）。
需要长期护理的老年人腿部骨骼肌质量不对称指数与步速相关。未来针对腿部骨骼肌质量对称性的评估和干预可能有助于改善老年人的步速。
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