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老年人的骨骼肌健康、身体机能和下尿路症状:肌肉、移动性和衰老研究。

Skeletal Muscle Health, Physical Performance, and Lower Urinary Tract Symptoms in Older Adults: The Study of Muscle, Mobility, and Aging.

机构信息

Department of Medicine, University of California and the San Francisco Veterans Affairs Medical Center, San Francisco, California, USA.

Department of Urology, University of California, San Francisco, California, USA.

出版信息

J Gerontol A Biol Sci Med Sci. 2024 Jun 1;79(6). doi: 10.1093/gerona/glad218.

Abstract

BACKGROUND

Lower urinary tract symptoms (LUTS) and mobility limitations are bidirectionally associated among older adults, but the role of skeletal muscle remains unknown. We evaluated cross-sectional associations of muscle health and physical performance with LUTS.

METHODS

We used data from 377 women and 264 men aged >70 years in the Study of Muscle, Mobility and Aging (SOMMA). LUTS and urinary bother were assessed using the LURN Symptom Index-10 (SI-10; higher = worse symptoms). Muscle mass and volume were assessed using D3-creatine dilution (D3Cr) and magnetic resonance imaging. Grip strength and peak leg power assessed upper/lower extremity physical performance. 400-m walk, Short Physical Performance Battery (SPPB), and Four Square Step Test (FSST) assessed global physical performance. Mobility Assessment Tool-short form (MAT-sf) assessed self-reported mobility. We calculated Spearman correlation coefficients adjusted for age, body mass index, multimorbidity, and polypharmacy, chi-square tests, and Fisher's Z-test to compare correlations.

RESULTS

Among women, LURN SI-10 total scores were inversely correlated with FSST (rs = 0.11, p = .045), grip strength (rs = -0.15, p = .006), and MAT-sf (rs = -0.18, p = .001), but not other muscle and physical performance measures in multivariable models. LURN SI-10 was not associated with any of these measures among men. Forty-four percent of women in the lowest tertile of 400-m walk speed versus 24% in the highest tertile reported they were at least "somewhat bothered" by urinary symptoms (p < .001), whereas differences among men were not significant.

CONCLUSIONS

Balance and grip strength were associated with LUTS severity in older women but not men. Associations with other muscle and physical performance measures varied by LUTS subtype but remained strongest among women.

摘要

背景

下尿路症状(LUTS)和活动受限在老年人中呈双向关联,但骨骼肌肉的作用尚不清楚。我们评估了肌肉健康和身体表现与 LUTS 的横断面关联。

方法

我们使用了年龄>70 岁的研究肌肉、移动性和衰老(SOMMA)中 377 名女性和 264 名男性的数据。使用 LURN 症状指数-10(SI-10;分数越高症状越严重)评估 LUTS 和尿困扰。使用 D3-肌酸稀释(D3Cr)和磁共振成像评估肌肉质量和体积。握力和峰值腿部力量评估上下肢身体表现。400 米步行、短体物理性能电池(SPPB)和四方步测试(FSST)评估整体身体表现。移动性评估工具-短表(MAT-sf)评估自我报告的移动性。我们计算了调整年龄、体重指数、多种合并症和多种药物治疗后 Spearman 相关系数,进行了卡方检验和 Fisher's Z 检验以比较相关性。

结果

在女性中,LURN SI-10 总分与 FSST(rs=0.11,p=0.045)、握力(rs=-0.15,p=0.006)和 MAT-sf(rs=-0.18,p=0.001)呈负相关,但在多变量模型中与其他肌肉和身体表现测量值无关。LURN SI-10 与男性中的这些测量值均无关联。400 米步行速度最低三分位的女性中有 44%报告至少“有些困扰”尿症状,而最高三分位的女性中这一比例为 24%(p<0.001),而男性之间的差异则不显著。

结论

平衡和握力与老年女性的 LUTS 严重程度相关,但与男性无关。与其他肌肉和身体表现测量值的关联因 LUTS 亚型而异,但在女性中仍然最强。

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