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中国西部老年人肌肉减少症分级与跌倒史的关系:一项回顾性研究。

Association between sarcopenia grade and fall history among older adults in West China: A retrospective study.

机构信息

Department of Traditional Chinese Medicine, Chengdu Eighth People's Hospital (Geriatric Hospital of Chengdu Medical College), Chengdu, Sichuan, China.

Sichuan University West China Hospital National Clinical Research Center for Geriatrics, Chengdu, Sichuan, China.

出版信息

BMJ Open. 2024 Feb 20;14(2):e080426. doi: 10.1136/bmjopen-2023-080426.

Abstract

OBJECTIVES

The association between sarcopenia severity and fall history remains under-researched at present. Accordingly, this study was developed to evaluate the relationship between sarcopenic status and prior fall events in a multiethnic group of older community-dwelling adults in Western China.

DESIGN

A retrospective survey study, the data comes from the West China Health and Aging Trend study.

SETTING

The study was based in Western China.

PARTICIPANTS

In total, this retrospective analysis incorporated data from 2719 older adults (59.2% women).

PRIMARY AND SECONDARY OUTCOME MEASURES

Grip strength, gait speed and skeletal muscle mass index values were analysed for all participants, and the Asian Working Group for Sarcopenia (AWGS) 2014 and 2019 consensus criteria were leveraged to assess sarcopenia status in these individuals. Prior fall history was defined by any incidents in which an individual unintentionally came to rest on the floor within the past year. The association between sarcopenia status and fall history was examined through a binary logistic regression approach, with p<0.05 as the threshold for significance.

RESULTS

Using the AWGS2014 and AWGS2019 diagnostic criteria, of the individuals included in this study cohort 1851 (68.1%) were free of sarcopenia, 160 (5.9%) and 56 (2.1%) showed only muscle-mass loss, 322 (11.8%) and 267 (9.8%) exhibited non-severe sarcopenia and the remaining 386 (14.2%) and 545 (20.0%) exhibited severe sarcopenia, respectively. Previous fall events were reported for 14.8% of study cohort members. After full adjustment for potential confounders, a significant link between severe sarcopenia diagnosed by the AWGS2014 diagnostic criteria and fall history was observed (OR 1.397, 95% CI 1.029 to 1.896, p=0.032), while the AWGS2019 diagnostic criteria did not (OR 1.29, 95% CI 0.982 to 1.694, p=0.068).

CONCLUSIONS

Severe sarcopenia, as defined per the AWGS2014 criteria, was associated with a significantly higher risk of falls in this multiethnic cohort of older adults from Western China, while the AWGS2019 diagnostic criteria did not. However, this relationship was not observed for individuals who experienced muscle mass loss or had non-severe sarcopenia, according to both the AWGS2014 and AWGS2019 diagnostic criteria.

摘要

目的

目前,肌肉减少症严重程度与跌倒史之间的关联仍研究不足。因此,本研究旨在评估在中国西部一个多民族的老年社区居住成年人中,肌肉减少症状态与既往跌倒事件之间的关系。

设计

回顾性调查研究,数据来自华西健康与老龄化趋势研究。

地点

本研究基于中国西部。

参与者

共有 2719 名老年人(59.2%为女性)参与了这项回顾性分析。

主要和次要观察指标

对所有参与者进行握力、步速和骨骼肌质量指数值分析,并利用亚洲肌肉减少症工作组(AWGS)2014 年和 2019 年共识标准评估这些个体的肌肉减少症状态。既往跌倒史定义为过去 1 年内个人因意外摔倒在地板上的任何事件。通过二元逻辑回归方法检查肌肉减少症状态与跌倒史之间的关联,以 p<0.05 为显著性阈值。

结果

使用 AWGS2014 和 AWGS2019 诊断标准,在所纳入的研究队列中,1851 名(68.1%)个体无肌肉减少症,160 名(5.9%)和 56 名(2.1%)仅表现为肌肉质量损失,322 名(11.8%)和 267 名(9.8%)表现为非严重肌肉减少症,其余 386 名(14.2%)和 545 名(20.0%)表现为严重肌肉减少症。研究队列中有 14.8%的成员报告有既往跌倒事件。在充分调整潜在混杂因素后,发现 AWGS2014 诊断标准诊断的严重肌肉减少症与跌倒史之间存在显著关联(OR 1.397,95%CI 1.029 至 1.896,p=0.032),而 AWGS2019 诊断标准则没有(OR 1.29,95%CI 0.982 至 1.694,p=0.068)。

结论

根据 AWGS2014 标准定义的严重肌肉减少症与中国西部这个多民族老年人群的跌倒风险显著增加相关,而 AWGS2019 诊断标准则没有。然而,根据 AWGS2014 和 AWGS2019 诊断标准,对于经历肌肉质量损失或非严重肌肉减少症的个体,并未观察到这种关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fd9/10882337/203ef57193e4/bmjopen-2023-080426f01.jpg

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