Visser Marjolein, Sääksjärvi Katri, Burchell George L, Schaap Laura A
Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Van der Boechorststraat 3, 1081 BT, Amsterdam, The Netherlands.
Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Eur Geriatr Med. 2025 May 23. doi: 10.1007/s41999-025-01230-y.
The aim of this review is to investigate the prospective association between muscle mass and physical functioning in older adults, and to explore sources of variability in this association.
Three databases were searched for prospective, observational studies investigating any assessment of muscle mass and functional decline in older adults (mean age 65 + years). 72 studies were included. Meta-analyses using results of the most adjusted statistical models were performed using Review Manager version 5.3.5.
Most studies were conducted in the community setting (n = 64) and used incident ADL limitations/disability as outcome (n = 44). Across studies, 6 body composition methods and 34 different parameters of muscle mass were used, including ratios. Average follow-up time was 46 months. For low versus higher muscle mass (n = 25), the overall odds ratio (OR) for functional decline was 1.23 (95% CI 1.10-1.37, I = 70%). Per SD higher muscle mass (n = 15), the overall OR was 0.89 (0.83-0.96, 76%). In general, no associations were observed when no adjustment for body size, or for body height only, was made. Associations were generally stronger when muscle mass was expressed as ratio of body weight, BMI or fat mass, or when more accurate body composition methods or objective performance tests were used.
In contrast to earlier reviews, this updated review shows that lower muscle mass is associated with higher risk of functional decline in older adults. Earlier observed variability in this association is explained by body composition method, body size adjustment, and type of physical functioning outcome.
本综述旨在研究老年人肌肉量与身体功能之间的前瞻性关联，并探讨该关联中变异性的来源。
检索了三个数据库，以查找有关老年人（平均年龄65岁及以上）肌肉量评估和功能衰退的前瞻性观察性研究。共纳入72项研究。使用Review Manager 5.3.5软件，对调整程度最高的统计模型结果进行荟萃分析。
大多数研究在社区环境中进行（n = 64），并将日常生活活动能力受限/残疾的发生情况作为结局指标（n = 44）。在各项研究中，使用了6种身体成分测量方法和34个不同的肌肉量参数，包括比值。平均随访时间为46个月。对于肌肉量较低与较高的情况（n = 25），功能衰退的总体优势比（OR）为1.23（95% CI 1.10 - 1.37，I² = 70%）。肌肉量每增加一个标准差（n = 15），总体OR为0.89（0.83 - 0.96，I² = 76%）。一般来说，在未对体型或仅对身高进行调整时，未观察到关联。当肌肉量以体重、体重指数或脂肪量的比值表示，或使用更精确的身体成分测量方法或客观性能测试时，关联通常更强。
与早期综述不同，本次更新综述表明，老年人肌肉量较低与功能衰退风险较高相关。早期观察到的该关联中的变异性可通过身体成分测量方法、体型调整和身体功能结局类型来解释。
