Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community-dwelling seniors age 65 and older
Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community-dwelling seniors age 65 and older
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DOI：
10.1007/s00198-015-3194-y
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发表时间：
2015-12-01
影响因子：
4
通讯作者：
Dawson-Hughes, B.
中科院分区：
文献类型：
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作者：
Bischoff-Ferrari, H. A.;Orav, J. E.;Dawson-Hughes, B.
在这项研究中，我们比较了七个可用的肌肉减少症定义和两个相关定义预测下降率的程度。我们的研究结果表明，Baumgartner和Cruz-Jentoft的定义最好地预测了肌肉减少症与非肌肉减少症社区老年人的跌倒率。本研究的目的是比较七个可用的肌少症定义和两个相关定义对预期跌倒率的预测程度。方法：我们研究了445名老年人（平均年龄71岁，男性占45%），他们住在社区，并进行了为期3年的详细跌倒评估。为了比较肌肉减少症患者与非肌肉减少症患者的下降率，我们使用了多变量泊松回归分析，调整了性别和治疗（原始干预测试了维生素D加钙与安慰剂对照）。在七个可用的定义中，三个仅仅基于低瘦质量（Baumgartner， Delmonico 1和2），四个同时需要低肌肉质量和功能测试中的性能下降（Fielding, Cruz-Jentoft, Morley, Muscaritoli）。这两个相关的定义是基于低瘦体重（Studenski 1）和低瘦体重导致虚弱（Studenski 2）。结果在445名参与者中，231人跌倒，在3年的随访中持续跌倒514次。肌肉减少症患者与非肌肉减少症患者的预期下降率最好通过Baumgartner定义（RR = 1.54; 95% CI 1.09-2.18）和Cruz-Jentoft定义（RR = 1.82; 95% CI 1.24-2.69）来预测，前者仅基于低瘦体重加功能表现下降（RR = 1.82; 95% CI 1.24-2.69），骨骼肌减少症患病率为7.1%。根据Delmonico 1、Fielding和Morley的定义，肌肉减少症患者与非肌肉减少症患者的跌倒率一致地没有显著性增高。结论在调查的定义中，Baumgartner定义和Cruz-Jentoft定义对预测跌倒率的效度最高。
In this study, we compare the extent to which seven available definitions of sarcopenia and two related definitions predict the rate of falling. Our results suggest that the definitions of Baumgartner and Cruz-Jentoft best predict the rate of falls among sarcopenic versus non-sarcopenic community-dwelling seniors.Introduction The purpose of the study is to compare the extent to which seven available definitions of sarcopenia and two related definitions predict the prospective rate of falling.Methods We studied a cohort of 445 seniors (mean age 71 years, 45 % men) living in the community who were followed with a detailed fall assessment for 3 years. For comparing the rate of falls in sarcopenic versus non-sarcopenic individuals, we used multivariate Poisson regression analyses adjusting for gender and treatment (original intervention tested vitamin D plus calcium against placebo). Of the seven available definitions, three were based on low lean mass alone (Baumgartner, Delmonico 1 and 2) and four required both low muscle mass and decreased performance in a functional test (Fielding, Cruz-Jentoft, Morley, Muscaritoli). The two related definitions were based on low lean mass alone (Studenski 1) and low lean mass contributing to weakness (Studenski 2).Results Among 445 participants, 231 fell, sustaining 514 falls over the 3-year follow-up. The prospective rate of falls in sarcopenic versus non-sarcopenic individuals was best predicted by the Baumgartner definition based on low lean mass alone (RR = 1.54; 95% CI 1.09-2.18) with 11% prevalence of sarcopenia and the Cruz-Jentoft definition based on low lean mass plus decreased functional performance (RR = 1.82; 95 % CI 1.24-2.69) with 7.1 % prevalence of sarcopenia. Consistently, fall rate was non-significantly higher in sarcopenic versus non-sarcopenic individuals based on the definitions of Delmonico 1, Fielding, and Morley.Conclusion Among the definitions investigated, the Baumgartner definition and the Cruz-Jentoft definition had the highest validity for predicting the rate of falls.