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老年人的运动机能不全综合征与肌肉骨骼疾病发病率增加:一项前瞻性研究。

Locomotive syndrome and increased musculoskeletal disorder incidence in older adults: a prospective study.

作者信息

Kitsuda Yuki, Matsumoto Hiromi, Tanimura Chika, Wada Takashi, Tanishima Shinji, Takeda Chikako, Osaki Mari, Nagashima Hideki, Hagino Hiroshi

机构信息

Rehabilitation Division, Tottori University Hospital, 683-8504 36-1 Nishi-cho, Yonago, Tottori, Japan.

Department of Physical Therapy, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Matsushima, Kurashiki, Okayama, 701-0193 288, Japan.

出版信息

J Bone Miner Metab. 2025 Jun 5. doi: 10.1007/s00774-025-01607-w.

Abstract

INTRODUCTION

With the population aging, musculoskeletal disorders increasingly impair older adults' quality of life and escalating healthcare costs, necessitating effective prevention strategies. Locomotive syndrome (LS), characterized by mobility decline due to musculoskeletal dysfunction, is closely linked to these disorders. However, its role in predicting future musculoskeletal conditions remains unclear. This study examined the association between LS and the incidence of newly diagnosed musculoskeletal disorders.

MATERIAL AND METHODS

This prospective study included 367 community-dwelling adults aged ≥ 40 years who were independent in daily activities. LS was assessed using the five-question Geriatric Locomotive Function Scale (GLFS-5). The primary outcome was the incidence of musculoskeletal disorders, including osteoarthritis, lumbar spinal stenosis, and osteoporosis. Cox proportional hazards regression analyzed associations between LS and future diagnoses, while receiver operating characteristic (ROC) analysis determined the GLFS-5 cutoff score for risk prediction.

RESULTS

At baseline, 19.1% of participants had LS. Over four years, musculoskeletal disorders occurred more frequently in participants with LS than in those without (22.2 vs. 8.8 per 100 person-years, p < 0.001). After adjusting for covariates, LS remained a significant risk factor (hazard ratio 1.98, 95% confidence interval 1.16-3.36, p = 0.011). ROC analysis identified a GLFS-5 cutoff score of 2 (sensitivity: 62.0%, specificity: 62.0%).

CONCLUSIONS

LS nearly doubled the risk of musculoskeletal disorders, with a GLFS-5 score ≥ 2 serving as an early risk indicator. Proactive screening and targeted interventions may mitigate this risk in aging populations.

摘要

引言

随着人口老龄化,肌肉骨骼疾病日益损害老年人的生活质量,并使医疗费用不断攀升,因此需要有效的预防策略。运动机能综合征(LS)以肌肉骨骼功能障碍导致的活动能力下降为特征,与这些疾病密切相关。然而,其在预测未来肌肉骨骼疾病方面的作用仍不明确。本研究探讨了LS与新诊断的肌肉骨骼疾病发病率之间的关联。

材料与方法

这项前瞻性研究纳入了367名年龄≥40岁、日常生活能够自理的社区居住成年人。使用包含五个问题的老年运动机能功能量表(GLFS-5)评估LS。主要结局是肌肉骨骼疾病的发病率,包括骨关节炎、腰椎管狭窄症和骨质疏松症。采用Cox比例风险回归分析LS与未来诊断之间的关联,同时通过受试者工作特征(ROC)分析确定用于风险预测的GLFS-5临界值。

结果

在基线时,19.1%的参与者患有LS。在四年时间里,患有LS的参与者比未患LS的参与者肌肉骨骼疾病的发生频率更高(每100人年分别为22.2例和8.8例,p<0.001)。在对协变量进行调整后,LS仍然是一个显著的风险因素(风险比1.98,95%置信区间1.16 - 3.36,p = 0.011)。ROC分析确定GLFS-5临界值为2(敏感性:62.0%,特异性:62.0%)。

结论

LS使肌肉骨骼疾病的风险几乎增加了一倍,GLFS-5评分≥2可作为早期风险指标。积极的筛查和针对性干预可能会降低老年人群中的这种风险。

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