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墨西哥裔美国老年人的多重疾病、肌肉力量与跌倒

Multimorbidity, Muscle Strength, and Falls among Older Mexican Americans.

作者信息

Uribe Alondra, Al Snih Soham

机构信息

John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, USA.

Department of Population Health and Health Disparities/School of Public and Population Health, The University of Texas Medical Branch, Galveston, TX, USA; Division of Geriatrics Medicine/Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX, USA; Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX, USA.

出版信息

J Am Med Dir Assoc. 2025 Jul;26(7):105613. doi: 10.1016/j.jamda.2025.105613. Epub 2025 May 14.

DOI:10.1016/j.jamda.2025.105613
PMID:40318694
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12218926/
Abstract

OBJECTIVES

Multimorbidity is linked with an increased risk of falls in older adults. The study objective is to determine the relationship of multimorbidity and muscle strength in falls among older Mexican Americans without a history of falls at baseline.

DESIGN

Longitudinal study.

SETTING AND PARTICIPANTS

This 12-year prospective cohort study included 899 noninstitutionalized Mexican Americans aged ≥75 years residing in Arizona, California, Colorado, New Mexico, and Texas from the Hispanic Established Population for the Epidemiologic Study of the Elderly (HEPESE).

METHODS

Measures include the following: sociodemographics, medical conditions, body mass index, disability, handgrip strength (HGS), depressive symptoms, pain, cognitive function, and multimorbidity (≥2 self-reported medical conditions). Participants at baseline were divided into the following 4 groups: high HGS and multimorbidity (n = 349), low HGS and multimorbidity (n = 263), high HGS and without multimorbidity (n = 181), and low HGS and without multimorbidity (n = 104). Generalized estimating equation models estimated the odds ratio (OR) and 95% CI for falls as a function of multimorbidity and HGS group, controlling for all covariates.

RESULTS

The mean sample age ± SD was 81.0 ± 4.3 years, and 55.9% were female. The OR for falls was 0.70 (95% CI, 0.52-0.94) for those with multimorbidity and high HGS, 0.50 (95% CI, 0.32-0.80) for those without multimorbidity and high HGS, and 0.46 (95% CI, 0.29-0.74) for those without multimorbidity and low HGS, vs those with multimorbidity and low HGS, after controlling for all covariates.

CONCLUSIONS AND IMPLICATIONS

Mexican American older adults with multimorbidity and high HGS had a 30% decreased risk of falls over time. Increasing muscle strength through exercise may help prevent falls among those with multimorbidity.

摘要

目的

多种疾病并存与老年人跌倒风险增加有关。本研究的目的是确定在基线时无跌倒史的墨西哥裔美国老年人中,多种疾病并存与肌肉力量在跌倒方面的关系。

设计

纵向研究。

设置与参与者

这项为期12年的前瞻性队列研究纳入了899名年龄≥75岁、居住在亚利桑那州、加利福尼亚州、科罗拉多州、新墨西哥州和得克萨斯州的非机构化墨西哥裔美国人,他们来自西班牙裔老年人流行病学研究的既定人群(HEPESE)。

方法

测量指标包括以下方面:社会人口统计学、医疗状况、体重指数、残疾情况、握力(HGS)、抑郁症状、疼痛、认知功能以及多种疾病并存(自我报告的≥2种医疗状况)。基线时的参与者被分为以下4组:高握力且多种疾病并存(n = 349)、低握力且多种疾病并存(n = 263)、高握力且无多种疾病并存(n = 181)以及低握力且无多种疾病并存(n = 104)。广义估计方程模型估计了作为多种疾病并存和握力组函数的跌倒比值比(OR)和95%置信区间(CI),并对所有协变量进行了控制。

结果

样本的平均年龄±标准差为81.0±4.3岁,55.9%为女性。在控制所有协变量后,与多种疾病并存且低握力的人群相比,多种疾病并存且高握力人群的跌倒OR为0.70(95% CI,0.52 - 0.94),无多种疾病并存且高握力人群的跌倒OR为0.50(95% CI,0.32 - 0.80),无多种疾病并存且低握力人群的跌倒OR为0.46(95% CI,0.29 - 0.74)。

结论与启示

随着时间推移,患有多种疾病且握力高的墨西哥裔美国老年人跌倒风险降低了30%。通过锻炼增加肌肉力量可能有助于预防多种疾病并存人群的跌倒。

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