Yamaguchi Ryo, Makino Keitaro, Katayama Osamu, Yamagiwa Daiki, Shimada Hiroyuki
Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan; Medical Science Division, Department of Medical Sciences, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Nagano 390-8621, Japan.
Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan; Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Hokkaido 060-0812, Japan.
J Nutr Health Aging. 2025 Mar;29(3):100452. doi: 10.1016/j.jnha.2024.100452. Epub 2024 Dec 19.
To examine the combined association of physical inactivity and depressive symptoms with the progression to sarcopenia in community-dwelling older adults.
A 4-year follow-up longitudinal study.
Community-dwelling older adults living in Japan, who were not sarcopenic at baseline.
The participants were 2,538 community-dwelling older adults and with a mean age of 70.9 ± 4.6 years, of whom 1,327 (52.3%) were women.
Sarcopenia, defined according to the European Working Group on Sarcopenia in Older People 2, was assessed at baseline and at the 4-year follow-up. Participants were divided into four groups according to their inactivity and depressive symptoms. Physical inactivity was assessed using two face-to-face questions regarding the frequency of regular exercise, sports, and light exercise per week. Depressive symptoms were defined as a score of six or higher on the Geriatric Depression Scale 15-item version. Logistic regression analysis was used to determine whether inactivity and depressive symptoms were associated with progression to sarcopenia 4 years later. For participants who could not be followed and participants with missing data in the follow-up assessment, the data at the follow-up assessment were imputed using the multiple imputations.
After 4 years, 518 participants (20.4%) with complete data progressed to sarcopenia. The rate of progression to sarcopenia after multiple imputations was 23.4%. Logistic regression analysis after multiple imputations showed that the group with both factors was significantly associated with the progression to sarcopenia [Odds ratio, 1.64 (95% Confidence interval 1.11-2.44), p = 0.014]. By contrast, no significant association was found for either inactivity or depressive symptoms alone.
This study indicates that the coexistence of physical inactivity and depressive symptoms may contribute to the progression of sarcopenia. Addressing both physical and mental factors, rather than limiting the problem to a single factor, may be essential for preventing sarcopenia.
探讨身体活动不足和抑郁症状与社区居住老年人肌肉减少症进展的联合关联。
一项为期4年的随访纵向研究。
居住在日本的社区老年人，基线时无肌肉减少症。
2538名社区居住老年人，平均年龄70.9±4.6岁，其中1327名（52.3%）为女性。
根据欧洲老年人肌肉减少症工作组2的定义，在基线和4年随访时评估肌肉减少症。参与者根据其身体活动不足和抑郁症状分为四组。身体活动不足通过两个关于每周定期锻炼、运动和轻度锻炼频率的面对面问题进行评估。抑郁症状定义为老年抑郁量表15项版本得分6分或更高。采用逻辑回归分析确定身体活动不足和抑郁症状是否与4年后肌肉减少症的进展相关。对于无法随访的参与者和随访评估中数据缺失的参与者，随访评估数据采用多重填补法进行估算。
4年后，518名（20.4%）有完整数据的参与者进展为肌肉减少症。多重填补后肌肉减少症的进展率为23.4%。多重填补后的逻辑回归分析表明，两个因素都存在的组与肌肉减少症的进展显著相关[比值比，1.64（95%置信区间1.11 - 2.44），p = 0.014]。相比之下，单独的身体活动不足或抑郁症状均未发现显著关联。
本研究表明，身体活动不足和抑郁症状并存可能导致肌肉减少症的进展。解决身体和心理因素，而非将问题局限于单一因素，可能对预防肌肉减少症至关重要。
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