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从老年人角度看干预措施对肌肉减少症的影响:系统文献回顾。

Impact of Interventions on Sarcopenia from the Perspective of Older Persons: A Systematic Literature Review.

机构信息

Professor Charlotte Beaudart, Clinical Pharmacology and Toxicology Research Unit (URCP), Namur Research Institute for Life Sciences (NARILIS), Department of Biomedical Sciences, Faculty of Medicine, University of Namur, Namur, Belgium, Email:

出版信息

J Frailty Aging. 2024;13(3):224-232. doi: 10.14283/jfa.2024.47.

Abstract

Current interventions targeting sarcopenia are diverse, incorporating a blend of nutritional, exercise, and pharmacological strategies. Although muscle mass, muscle strength, or functional performance typically serve as the primary endpoints, regulatory agencies have recently emphasized integrating Patient-Reported Outcome Measures (PROMs) as primary or secondary outcomes in interventional studies. This shift acknowledges the importance of PROMs and Patient-Reported Experience Measures (PREMs) in assessing intervention effectiveness and aligns with patient-centered healthcare models. The aims of this systematic review are 1) to identify all sarcopenia-designed interventional studies that used PROMs/PREMs as the primary or secondary outcome, 2) to identify the different PROMs/PREMs used within those studies, and 3) to summarize the effects of sarcopenia-designed interventions on PROMs/PREMs of sarcopenic participants. For that, a systematic search of databases (Medline, EMBASE, Review- Cochrane Central of Register of Controlled Trials, and PsychINFO (Via Ovid)) was conducted in September 2023. The review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement, and the protocol was registered on Open Science Framework (https://osf.io/zxgwm/). The systematic review identified 17 RCTs as sarcopenia-designed interventional studies reporting PROMs. PROMs covered the assessment of various aspects, including quality of life, depressive symptoms, loneliness/social isolation, daytime sleepiness, insomnia impact, and sleep quality/disturbance. Only one sarcopenia-specific PROM, namely the SarQoL, was reported. The effect of sarcopenia-designed interventions on PROMs showed considerable heterogeneity, underscoring the need for standardization in sarcopenia research by developing a Core Outcome Set (COS). COS in sarcopenia studies would ensure consistent and comparable findings, ultimately enhancing the reliability and effectiveness of interventions.

摘要

目前针对肌肉减少症的干预措施多种多样,综合了营养、运动和药物等策略。虽然肌肉质量、肌肉力量或功能表现通常作为主要终点,但监管机构最近强调在干预研究中纳入患者报告结局(PROs)作为主要或次要结局。这种转变承认了 PROs 和患者报告体验测量(PREMs)在评估干预效果中的重要性,并与以患者为中心的医疗保健模式保持一致。本系统评价的目的是:1)确定所有使用 PROs/PREMs 作为主要或次要结局的肌肉减少症设计干预研究,2)确定这些研究中使用的不同 PROs/PREMs,3)总结肌肉减少症设计干预对肌肉减少症参与者的 PROs/PREMs 的影响。为此,我们于 2023 年 9 月对数据库(Medline、EMBASE、Cochrane 中心对照试验注册库和 PsychINFO(通过 Ovid))进行了系统检索。本研究遵循系统评价和荟萃分析的 Preferred Reporting Items(PRISMA)声明,并在 Open Science Framework(https://osf.io/zxgwm/)上进行了方案注册。本系统评价确定了 17 项 RCT 作为肌肉减少症设计的干预研究,报告了 PROs。PROs 涵盖了各种方面的评估,包括生活质量、抑郁症状、孤独/社会隔离、白天嗜睡、失眠影响和睡眠质量/障碍。仅报告了一种肌肉减少症特异性 PRO,即 SarQoL。肌肉减少症设计干预对 PROs 的影响存在相当大的异质性,这突出表明需要通过制定核心结局集(COS)来标准化肌肉减少症研究。在肌肉减少症研究中使用 COS 将确保一致和可比的发现,最终提高干预措施的可靠性和有效性。

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