Moyes Simon A, Selak Vanessa, Plank Lindsay, Hikaka Joanna, Kerse Ngaire
Faculty of Medical and Health Sciences, Department of General Practice & Primary Healthcare, School of Population Health, University of Auckland, PO Box 92019, Auckland, 1142, New Zealand.
Faculty of Medical and Health Sciences, Department of Epidemiology & Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand.
Eur Geriatr Med. 2025 Jun 28. doi: 10.1007/s41999-025-01261-5.
As the population is ageing, age-related vulnerability to chronic infirmity has become of greater concern. Sarcopenia, low muscle strength and mass, is a major contributor to infirmity. Both sarcopenia and hand grip strength (HGS) are known to predict mortality in older people. This paper investigates the impact of ethnicity on this relationship in New Zealand octogenarians.
This study used data from Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ), which recruited 421 Māori and 516 non-Māori with follow-up mortality data for over twelve years and had a median survival period of 6.02 years, 251 Māori and 374 non-Māori had sufficient data to be included in modelling. Survival analysis (Cox regression) assessed the association between HGS or probable sarcopenia (defined using HGS) and mortality, separately by ethnicity (Māori, non-Māori) and sex.
Hand grip strength was a predictor of mortality for non-Māori men (age-adjusted hazard ratio, aHR, per 1 kg increase in HGS, 0.93, 95% CI: 0.91-0.96) but not for women or Māori men. Probable sarcopenia was associated with an increased hazard of mortality among all groups, but the effect was statistically significant for non-Māori (men 1.97, 1.39-2.79; women 1.49, 1.08-2.06) and not Māori (men 1.55, 0.97-2.48; women 1.36, 0.79-2.34).
Hand grip strength, either as a continuous variable or to identify probable sarcopenia, remains an important indicator with high clinical utility in advanced age. However, its utility may need to be re-examined for Indigenous populations.
随着人口老龄化，与年龄相关的慢性虚弱易感性已成为更受关注的问题。肌肉减少症，即肌肉力量和质量低下，是导致虚弱的主要因素。已知肌肉减少症和握力（HGS）均可预测老年人的死亡率。本文研究了种族对新西兰八旬老人这种关系的影响。
本研究使用了来自《高龄生活与生存：新西兰队列研究》（LiLACS NZ）的数据，该研究招募了421名毛利人和516名非毛利人，并拥有超过十二年的随访死亡率数据，中位生存期为6.02年，251名毛利人和374名非毛利人有足够的数据纳入模型。生存分析（Cox回归）分别按种族（毛利人、非毛利人）和性别评估了握力或可能的肌肉减少症（使用握力定义）与死亡率之间的关联。
握力是非毛利男性死亡率的预测指标（年龄调整风险比，aHR，握力每增加1千克，为0.93，95%置信区间：0.91 - 0.96），但对女性或毛利男性则不然。可能的肌肉减少症与所有组的死亡风险增加相关，但该效应在非毛利人中具有统计学意义（男性为1.97，1.39 - 2.79；女性为1.49，1.08 - 2.06），而在毛利人中则无统计学意义（男性为1.55，0.97 - 2.48；女性为1.36，0.79 - 2.34）。
握力，无论是作为连续变量还是用于识别可能的肌肉减少症，在高龄人群中仍然是具有高临床效用的重要指标。然而，对于原住民群体，可能需要重新审视其效用。
