Comparison of quadriceps strength and handgrip strength in their association with health outcomes in older adults in primary care
Comparison of quadriceps strength and handgrip strength in their association with health outcomes in older adults in primary care
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DOI：
10.1007/s11357-014-9714-4
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发表时间：
2014-10-01
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影响因子：
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通讯作者：
den Elzen, Wendy P. J.
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作者：
Chan, On Ying A.;van Houwelingen, Anne H.;den Elzen, Wendy P. J.
肌肉减少症被认为在老年出现的功能障碍中发挥着重要作用。在临床实践中，肌肉减少症通常通过测量握力来确定。在这里，我们比较了下肢股四头肌力量和握力与初级保健老年人健康结果的关系。我们的研究人群包括参加老年人综合系统护理 (ISCOPE) 研究的老年人（n=764，其中 68.2% 为女性，中位年龄 83 岁）。在基线时访问参与者以测量股四头肌力量和握力。在基线和 12 个月后获得健康结果数据（包括生活满意度、日常生活残疾、全科医生联系时间和住院治疗）。股四头肌力量和握力呈弱相关性（β=0.42 [95% CI 0.33-0.50]；R-2=0.17）。股四头肌力量和握力与基线健康结果独立相关，包括生活质量、日常生活残疾、全科医生接触时间、住院治疗和步态速度。股四头肌和握力的综合弱点是最脆弱的亚群，其健康状况最差。随访时，握力显示与生活质量（β=0.05；P=0.002）和日常生活障碍（β=-0.5；P=0.004）相关。股四头肌无力并没有进一步有助于预测所测量的健康结果。我们的结论是，老年人群中股四头肌力量与握力只有中度相关，股四头肌力量和握力测量的结合可能有助于识别初级保健中健康状况最差的老年人。在预测不良健康结果时，股四头肌力量测量并没有显示出握力的附加值。
Sarcopenia is thought to play a major role in the functional impairment that occurs with old age. In clinical practice, sarcopenia is often determined by measuring handgrip strength. Here, we compared the lower limb quadriceps strength to the handgrip strength in their association with health outcomes in older adults in primary care. Our study population consisted of older adults (n=764, 68.2 % women, median age 83) that participated in the Integrated Systemic Care for Older People (ISCOPE) study. Participants were visited at baseline to measure quadriceps strength and handgrip strength. Data on health outcomes were obtained at baseline and after 12 months (including life satisfaction, disability in daily living, GP contact-time and hospitalization). Quadriceps strength and handgrip strength showed a weak association (beta=0.42 [95 % CI 0.33-0.50]; R-2=0.17). Quadriceps strength and handgrip strength were independently associated with health outcomes at baseline, including quality of life, disability in daily living, GP contact-time, hospitalization, and gait speed. Combined weakness of the quadriceps and handgrip distinguished a most vulnerable subpopulation that presented with the poorest health outcomes. At follow-up, handgrip strength showed an association with quality of life (beta=0.05; P=0.002) and disability in daily living (beta=-0.5; P=0.004). Quadriceps weakness did not further contribute to the prediction of the measured health outcomes. We conclude that quadriceps strength is only moderately associated with handgrip strength in an older population and that the combination of quadriceps strength and handgrip strength measurements may aid in the identification of older adults in primary care with the poorest health outcomes. In the prediction of poor health outcomes, quadriceps strength measurements do not show an added value to the handgrip strength.