Juby A G, Davis C M J, Minimaana S, Mager D R
Department of Medicine, Division of Geriatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Faculty of Kinesiology, University of Alberta, Edmonton, Alberta, Canada.
Heliyon. 2023 Sep 16;9(9):e20078. doi: 10.1016/j.heliyon.2023.e20078. eCollection 2023 Sep.
The prevalence of sarcopenia varies depending on the cohort evaluated, and the diagnostic criteria used. Older adults with sarcopenia report lower quality of life than their non-sarcopenic peers. Leisure physical activity is reported to have a variable effect on sarcopenic status. Most studies to date, have been done in "vulnerable" populations, with fewer done on independent community-dwelling older adults. None have been done in an Alberta, Canada population.
To prospectively evaluate the sarcopenic status of independent community-dwelling older Albertan adults; whether this changed over 12-months; and any association with self-reported leisure activity or quality of life.
Independent community-dwelling older adults were invited to participate in a 12-month observational study. Assessments were done at baseline, 6 and 12-months for physical function (TUG, SPPB, gait speed, Tinetti, grip strength), muscle mass (DXA, arm and calf circumference), body fat (skinfold, DXA), reported daily exercise (aerobic, resistance), quality of life (EQ5D), and laboratory parameters. European Working Group on Sarcopenia in Older People (EWGSOP) definitions of sarcopenic status were used.
All 50 participants (11 male), were independent of all basic activities of daily living at baseline, and most instrumental activities (some needed assistance with driving or finances). They had an average age of 75.8 (67-90) years, with average MMSE and MoCA cognitive scores of 28.1/30 (20-30) and 24.8/30 (14-30) respectively. Eight participants dropped out prior to their first DXA test. Of the remaining 42, 17 participants (5 male) fulfilled the EWGSOP revised criteria for probable, pre-sarcopenia, or sarcopenia, giving a rate of baseline total sarcopenia of 40.5% in this community-dwelling sample. The majority were pre-sarcopenic (28.6%), and sarcopenia was present only in 7.1%. The total sarcopenia group had a lower BMI (25.6 ± 5.1 versus 29 ± 5, p = 0.01), less body fat by skinfold measurement (36.4 ± 6.5 versus 39.3 ± 8.1, p = 0.01) and lower mid-calf (35.6 ± 3.2 versus 37.6 ± 3.4, p = 0.04) and mid-arm (29.1 ± 2.5 versus 31.9 ± 3.5, p = 0.02) circumferences when compared to their non-sarcopenic peers. After 12-months, 39 participants remained in the study. Of these, the sarcopenic status of 7 improved, 10 declined, with the remaining 56% not changing. There were no statistically significant differences in baseline laboratory parameters between the groups, including 25(OH)D status. But, of the status decliners, 40% had suboptimal 25(OH)D at baseline. Self-reported leisure activity (both total time and frequency) was not associated with sarcopenic status at 12-months. EuroQol -5D was not associated with sarcopenic status.
The rate of sarcopenia was 7.1%, but the total rate of pre, probable and sarcopenia in this highly functioning, community-dwelling older adult cohort was 40.5%. In the majority (75%), there was either no change, or an improvement, in their sarcopenic status over 12-months. There was no association identified with self-reported leisure activity or quality of life in this cohort.
肌肉减少症的患病率因所评估的队列以及所使用的诊断标准而异。与非肌肉减少症的同龄人相比，患有肌肉减少症的老年人报告生活质量较低。据报道，休闲体育活动对肌肉减少症状态有不同的影响。迄今为止，大多数研究是在“脆弱”人群中进行的，而针对独立居住在社区的老年人的研究较少。在加拿大艾伯塔省人群中尚未开展此类研究。
前瞻性评估独立居住在社区的艾伯塔省老年成年人的肌肉减少症状态；该状态在12个月内是否发生变化；以及与自我报告的休闲活动或生活质量的任何关联。
邀请独立居住在社区的老年成年人参与一项为期12个月的观察性研究。在基线、6个月和12个月时进行评估，内容包括身体功能（定时起立行走试验、简短体能状况量表、步速、Tinetti量表、握力）、肌肉量（双能X线吸收法、上臂和小腿围）、体脂（皮褶厚度、双能X线吸收法）、报告的日常锻炼（有氧运动、抗阻运动）、生活质量（EQ-5D量表）以及实验室参数。采用欧洲老年人肌肉减少症工作组（EWGSOP）对肌肉减少症状态的定义。
所有50名参与者（11名男性）在基线时均能独立完成所有基本日常生活活动，并且大多数能完成工具性日常生活活动（部分人在驾驶或理财方面需要协助）。他们的平均年龄为75.8（67 - 90）岁，简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA）的平均认知得分分别为28.1/30（20 - 30）和24.8/3（14 - 30）。8名参与者在首次双能X线吸收法测试前退出。在其余42名参与者中，17名参与者（5名男性）符合EWGSOP修订的可能、疑似或确诊肌肉减少症的标准，在这个社区居住样本中，基线时总体肌肉减少症的发生率为40.5%。大多数为疑似肌肉减少症（28.6%），确诊肌肉减少症仅占7.1%。与非肌肉减少症的同龄人相比，总体肌肉减少症组的体重指数较低（25.6±5.1对29±5，p = 0.01），通过皮褶厚度测量的体脂较少（36.4±6.5对39.3±8.1，p = 0.01），小腿中部（35.6±3.2对37.6±3.4，p = 0.04）和上臂中部（29.1±2.5对31.9±3.5，p = 0.02）周长较小。12个月后，39名参与者仍留在研究中。其中，7名参与者的肌肉减少症状态有所改善，10名有所下降，其余56%未发生变化。两组之间的基线实验室参数，包括25(OH)D状态，无统计学显著差异。但是，在状态下降者中，40%在基线时25(OH)D水平欠佳。自我报告的休闲活动（总时长和频率）与12个月时的肌肉减少症状态无关。欧洲五维度健康量表（EuroQol - 5D）与肌肉减少症状态无关。
肌肉减少症的发生率为7.1%，但在这个功能良好、居住在社区的老年成年人队列中，疑似和确诊肌肉减少症的总发生率为40.5%。在大多数人（75%）中，其肌肉减少症状态在12个月内没有变化或有所改善。在这个队列中，未发现与自我报告的休闲活动或生活质量之间存在关联。
