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阿尔茨海默病患者与非痴呆患者之间瘦体重和肌肉减少症的差异:一项观察性研究的系统评价和荟萃分析

Differences in lean mass and sarcopenia between individuals with Alzheimer's disease and those without dementia: A systematic review and meta-analysis of observational studies.

作者信息

Nazareth Camila Cristine Gomes, Scalli Ana Carolina Aparecida Marcondes, de Oliveira Marcos Paulo Braz, Gomes Antonio Felipe Souza, Brito-Costa Sonia, Furtado Guilherme Eustáquio, Cezar Natália Oiring de Castro

机构信息

Department of Medical Sciences, Minas Gerais State University, Minas Gerais, Brazil.

Departamento de Physiotherapy, Federal University of São Carlos, São Paulo, Brazil.

出版信息

J Alzheimers Dis. 2025 Jan;103(1):92-107. doi: 10.1177/13872877241299051. Epub 2024 Dec 16.

Abstract

BACKGROUND

Studies have observed that individuals with Alzheimer's disease (AD) tend to have lower lean mass and higher rates of sarcopenia.

OBJECTIVE

This review aims to assess differences in lean mass, sarcopenia, and its components between individuals with AD and those without dementia (WD).

METHODS

Searches were conducted in the Medline, Web of Science, Embase, Scopus and Latin American and Caribbean Health Scientific Literature. Observational studies comparing lean mass, sarcopenia, and its components in the populations of interest were included. We used the Joanna Briggs Institute (JBI) scale to assess methodological quality. Mean differences (MD) and standardized mean differences were calculated for the meta-analyses.

RESULTS

Four studies with 2035 individuals found that those with AD had significantly lower upper and lower limb lean mass, and skeletal muscle mass index compared to WD individuals. AD individuals also had a higher sarcopenia prevalence (41.33% versus 20.66%) and significant reductions in handgrip strength, lower limb muscle strength, and gait speed compared to WD individuals. The JBI scale analysis showed high agreement among the studies (k = 1.00, p = 0.046).

CONCLUSIONS

Individuals with AD have lower lean mass, higher rates of sarcopenia, and reduced muscle function compared to those without dementia. While the results suggest the need for early screening programs and integrated therapeutic interventions to improve clinical outcomes and quality of life for individuals with AD, it is important to consider that biases inherent in observational studies may compromise the quality of the evidence. Therefore, further research, preferably clinical trials, is needed to confirm these associations.

摘要

背景

研究观察到,阿尔茨海默病(AD)患者往往瘦体重较低且肌肉减少症发生率较高。

目的

本综述旨在评估AD患者与无痴呆症(WD)患者在瘦体重、肌肉减少症及其组成部分方面的差异。

方法

在Medline、科学网、Embase、Scopus以及拉丁美洲和加勒比健康科学文献数据库中进行检索。纳入比较目标人群中瘦体重、肌肉减少症及其组成部分的观察性研究。我们使用乔安娜·布里格斯研究所(JBI)量表评估方法学质量。为荟萃分析计算平均差异(MD)和标准化平均差异。

结果

四项涉及2035名个体的研究发现,与WD个体相比,AD患者的上肢和下肢瘦体重以及骨骼肌质量指数显著更低。与WD个体相比,AD患者的肌肉减少症患病率也更高(41.33%对20.66%),并且握力、下肢肌肉力量和步速显著降低。JBI量表分析显示各研究之间高度一致(k = 1.00,p = 0.046)。

结论

与无痴呆症患者相比,AD患者的瘦体重更低、肌肉减少症发生率更高且肌肉功能降低。虽然结果表明需要早期筛查项目和综合治疗干预措施来改善AD患者的临床结局和生活质量,但重要的是要考虑到观察性研究中固有的偏差可能会影响证据质量。因此,需要进一步研究,最好是临床试验,来证实这些关联。

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