Tabara Yasuharu, Ikezoe Tome, Setoh Kazuya, Kawaguchi Takahisa, Matsuda Fumihiko
Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, 420-0881, Japan; Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, 606-8507, Japan.
Faculty of Rehabilitation, Kansai Medical University, Hirakata, Osaka, 573-1136, Japan.
Arch Gerontol Geriatr. 2025 Feb;129:105670. doi: 10.1016/j.archger.2024.105670. Epub 2024 Oct 22.
Locomotive syndrome is a condition in which a person is at risk of requiring nursing care due to musculoskeletal disorders. The 25-question Geriatric Locomotive Function Scale (GLFS-25) was developed to determine the severity of locomotive syndrome. In this study, we aimed to determine the prognostic significance of the GLFS-25 for all-cause mortality.
The study participants consisted of 3,447 community residents aged ≥65 years. All-cause mortality was determined using residential registry records. Skeletal muscle mass assessed via bioimpedance methods was considered in the analysis as a confounding factor.
During a mean follow-up period of 3,236 days (30,566 person-years), 288 cases of all-cause mortality occurred. When participants were categorized by the GLFS-25 score [grade 1: <7 points (n = 1,948); grade 2: ≥7 to <16 points (n = 894); grade 3: ≥16 points (n = 605)], their survival probability decreased linearly with increasing grade (log-rank test P = 0.014). In a Cox proportional hazards model adjusted for confounding factors, including low skeletal muscle mass, GLFS-25 grade 3 was identified as an independent risk factor for all-cause mortality (hazard ratio: 1.60; P = 0.007) in the subpopulation aged ≥70 years but not in the overall population (P = 0.062). The hazard ratio for all-cause mortality with GLFS-25 grade 3 and low skeletal muscle mass combined was 2.66 (P < 0.001).
The GLFS-25 is independently associated with all-cause mortality in older adults. Using this questionnaire to assess locomotive syndrome could be useful for identifying individuals at risk.
运动机能不全综合征是一种由于肌肉骨骼疾病导致患者需要护理的病症。为确定运动机能不全综合征的严重程度，研发了包含25个问题的老年运动机能量表（GLFS-25）。在本研究中，我们旨在确定GLFS-25对全因死亡率的预后意义。
研究参与者包括3447名年龄≥65岁的社区居民。通过居民登记记录确定全因死亡率。分析中，将通过生物电阻抗法评估的骨骼肌质量作为混杂因素。
在平均3236天（30566人年）的随访期内，发生了288例全因死亡病例。当参与者按GLFS-25评分分类时[1级：<7分（n = 1948）；2级：≥7至<16分（n = 894）；3级：≥16分（n = 605）]，其生存概率随等级增加呈线性下降（对数秩检验P = 0.014）。在调整了包括低骨骼肌质量等混杂因素的Cox比例风险模型中，GLFS-25 3级被确定为≥70岁亚组全因死亡率的独立危险因素（风险比：1.60；P = 0.007），但在总体人群中并非如此（P = 0.062）。GLFS-25 3级与低骨骼肌质量共同作用时的全因死亡率风险比为2.66（P < 0.001）。
GLFS-25与老年人全因死亡率独立相关。使用该问卷评估运动机能不全综合征可能有助于识别有风险的个体。
