Department of Health Management, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.
Department of Public Health, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.
Aging Clin Exp Res. 2024 Feb 9;36(1):29. doi: 10.1007/s40520-023-02656-9.
Health-related quality of life (HRQoL), which can be influenced by various aspects, especially socioeconomic status and lifestyle, has been identified as an important predictor of the prognosis of older adults. Dietary habit, a major part of lifestyle, can affect the nutritional status, which is closely correlated with the development of geriatric syndromes in the elderly.
The aim of the study was to examine the association of HRQoL, socioeconomic status, and lifestyle with the risk and severity of sarcopenia, a geriatric syndrome characterized by progressive loss of skeletal muscle mass, strength and function.
A cross-sectional retrospective study with 2877 participants aged ≥65 years was performed. HRQoL was assessed using EuroQoL Five Dimensions questionnaire. Socioeconomic status was assessed by the educational attainment, occupation, and household income. Lifestyle was assessed using 12 items closely related to Chinese living habits. The information of daily dietary habits including tea, alcohol, type of diet, and volume of drinking water were collected. The associations of HRQoL, socioeconomic status, and lifestyle with the risk of sarcopenia were examined by multivariate regression logistical analysis. The potential causal role of age, body mass index, and waist circumference in the effect of HRQoL on sarcopenia risk was analyzed by causal mediation analysis.
High HRQoL [adjusted odds ratio (OR) =0.85, 95% confidence interval (CI) =0.69-0.95, P=0.034] and household income levels (adjusted OR =0.74, 95% CI =0.57-0.95, P=0.019) were inversely associated with the risk of sarcopenia. Meanwhile, more consumption of spicy food (adjusted OR =1.34, 95% CI =1.09-1.81, P =0.037) and occasionally drinking (adjusted OR =1.46, 95% CI =1.07-2.00, P =0.016, as compared to those never drinking) were associated with higher risk of sarcopenia, while skipping breakfast occasionally (adjusted OR =0.37, 95% CI =0.21-0.64, P <0.001, as compared to those eating breakfast every day) and less consumption of salt (adjusted OR =0.71, 95% CI =0.52-0.96, P =0.026, as compared to those consuming high amount of salt) were associated with lower risk of sarcopenia. Further causal mediation analysis aimed to explore how much age, body mass index, and waist circumference might explain the effect of HRQoL on the risk of sarcopenia showed that the estimated proportion that mediated the effect of HRQoL on the risk of sarcopenia by age was 28.0%.
In summary, our findings demonstrate that low levels of HRQoL and household income, more intake of salt and spicy food, and occasional intake of alcohol are correlated with higher risk of sarcopenia, while skipping breakfast occasionally is associated with lower risk of sarcopenia in a Chinese population of older adults.
健康相关生活质量（HRQoL）可受到多种因素的影响，尤其是社会经济地位和生活方式，它已被确定为老年人预后的重要预测指标。饮食习惯是生活方式的主要组成部分，它可以影响营养状况，而营养状况与老年人中老年综合征的发展密切相关。
本研究旨在探讨 HRQoL、社会经济地位和生活方式与肌肉减少症风险和严重程度的关系，肌肉减少症是一种以骨骼肌质量、力量和功能进行性丧失为特征的老年综合征。
进行了一项横断面回顾性研究，纳入了 2877 名年龄≥65 岁的参与者。使用 EuroQoL Five Dimensions 问卷评估 HRQoL。社会经济地位通过受教育程度、职业和家庭收入来评估。生活方式通过与中国生活习惯密切相关的 12 项指标进行评估。收集了包括茶、酒、饮食类型和饮水量在内的日常饮食习惯信息。使用多变量回归逻辑分析来检查 HRQoL、社会经济地位和生活方式与肌肉减少症风险的关系。通过因果中介分析来分析年龄、体重指数和腰围在 HRQoL 对肌肉减少症风险的影响中的潜在因果作用。
较高的 HRQoL[调整后的优势比（OR）=0.85，95%置信区间（CI）=0.69-0.95，P=0.034]和家庭收入水平（调整后的 OR=0.74，95%CI=0.57-0.95，P=0.019）与肌肉减少症风险呈负相关。同时，更多地食用辛辣食物（调整后的 OR=1.34，95%CI=1.09-1.81，P=0.037）和偶尔饮酒（调整后的 OR=1.46，95%CI=1.07-2.00，P=0.016，与从不饮酒相比）与更高的肌肉减少症风险相关，而偶尔不吃早餐（调整后的 OR=0.37，95%CI=0.21-0.64，P<0.001，与每天吃早餐相比）和低盐摄入（调整后的 OR=0.71，95%CI=0.52-0.96，P=0.026，与高盐摄入相比）与较低的肌肉减少症风险相关。进一步的因果中介分析旨在探讨年龄、体重指数和腰围在多大程度上可以解释 HRQoL 对肌肉减少症风险的影响，结果表明，HRQoL 对肌肉减少症风险的影响中，由年龄介导的比例估计为 28.0%。
总之，我们的研究结果表明，在中国老年人中，较低的 HRQoL 和家庭收入水平、较多的盐和辛辣食物摄入以及偶尔饮酒与肌肉减少症风险较高相关，而偶尔不吃早餐与肌肉减少症风险较低相关。
