Difference in sarcopenia characteristics associated with physical activity and disability incidences in older adults.
Difference in sarcopenia characteristics associated with physical activity and disability incidences in older adults.
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DOI：
10.1002/jcsm.12801
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Shimada H
中科院分区：
文献类型：
--
作者：
Chiba I;Lee S;Bae S;Makino K;Shinkai Y;Katayama O;Harada K;Takayanagi N;Shimada H
骨骼肌状况恶化，包括肌肉减少症，是老年人残疾的危险因素。促进体力活动是一种有效的治疗肌肉减少症。然而，根据肌肉减少症的特点，最佳的体力活动强度尚不清楚。这项纵向队列研究入组了2149名社区老年人（女性55.7%，平均年龄：75.5 ± 4.0岁）。根据日本长期护理保险认证和加速度计测量的身体活动定义的五年残疾发生率（低强度体力活动[LPA]和中至高强度体力活动[MVPA]），根据亚洲工作组的诊断算法，使用按少肌症特征分层的考克斯比例风险模型进行分析，并针对潜在混杂因素进行了调整。少肌症（健壮、低身体功能、低肌肉质量和少肌症）。肌肉减少症组定义为低肌肉质量和低身体功能（虚弱和/或缓慢）。低肌肉质量和低身体功能组各自仅由这些特征定义。通过生物电阻抗分析来分析肌肉质量。每种强度的体力活动时间除以中位数。排除无法随访者，残疾发生率为15.4%。所有参与者的平均LPA时间分别为43.8 ± 18.0、45.6 ± 17.5、45.4 ± 16.6、40.8 ± 18.6和41.4 ± 18.5分钟/天，MVPA时间分别为24.6 ± 17.6、26.3 ± 18.3、27.2 ± 17.3、21.6 ± 16.3和21.5 ± 16.4分钟/天，分别为健壮、低肌肉质量、低身体功能和肌肉减少症组。对于所有参与者，较高的MVPA与残疾发生率相关[风险比（HR），0.63; 95%置信区间（95%CI），0.49-0.81; P < 0.001]，而较高的LPA显示无相关性（HR，0.86; 95%CI，0.68-1.10; P = 0.22）。肌肉减少症组LPA较高（HR，0.35; 95% CI，0.15-0.85; P = 0.019），MVPA在稳健的（HR，0.58; 95% CI，0.39-0.87; P = 0.008）和低身体功能（HR，0.66; 95% CI，0.45-0.98; P = 0.040）组。LPA和MVPA在低肌肉质量组中均未显示相关性。少肌症特征和体力活动之间相互作用的P值为0.017（LPA）和0.014（MVPA）。LPA与患有肌肉减少症的老年人的残疾风险较低相关，而MVPA与身体功能强健和低的受试者相关。我们的研究结果表明，需要个性化的方法来预防基于肌肉状况的残疾。
Deteriorated skeletal muscle condition, including sarcopenia, is a risk factor for disability in older adults. Promoting physical activity is a useful treatment for sarcopenia. However, optimal intensity of physical activity according to sarcopenia characteristics is unclear. This longitudinal cohort study enrolled 2149 community‐dwelling older adults (women 55.7%, mean age: 75.5 ± 4.0 years). Five‐year disability incidence defined by Japanese long‐term care insurance certification and accelerometer‐measured physical activities (light‐intensity physical activity [LPA] and moderate‐to‐vigorous intensity physical activity [MVPA]), which were adjusted for potential confounders, was analysed using cox‐proportional hazard model stratified by sarcopenia characteristics based on the diagnostic algorithm by the Asian working group for sarcopenia (robust, low physical function, low muscle mass, and sarcopenia). The sarcopenia group was defined as low muscle mass and low physical function (weakness and/or slowness). The low muscle mass and low physical function groups were each defined by these characteristics alone. Muscle mass was analysed via bioelectrical impedance analysis. Each intensity of physical activity times was divided by median values. The disability incidence rate was 15.4%, excluding those who could not be followed up. Mean LPA times were 43.8 ± 18.0, 45.6 ± 17.5, 45.4 ± 16.6, 40.8 ± 18.6, and 41.4 ± 18.5 min/day and MVPA times were 24.6 ± 17.6, 26.3 ± 18.3, 27.2 ± 17.3, 21.6 ± 16.3, and 21.5 ± 16.4 min/day in all participants, the robust, low muscle mass, low physical function, and sarcopenia groups, respectively. For all participants, higher MVPA was associated with disability incidence [hazard ratios (HR), 0.63; 95% confidence interval (95% CI), 0.49–0.81; P < 0.001], whereas higher LPA showed no association (HR, 0.86; 95% CI, 0.68–1.10; P = 0.22). Higher LPA was associated in the sarcopenia group (HR, 0.35; 95% CI, 0.15–0.85; P = 0.019), and MVPA was associated in the robust (HR, 0.58; 95% CI, 0.39–0.87; P = 0.008) and low physical function (HR, 0.66; 95% CI, 0.45–0.98; P = 0.040) groups. Both LPA and MVPA showed no association in the low muscle mass group. The P values for interactions between sarcopenia characteristics and physical activity were 0.017 for LPA and 0.014 for MVPA. The LPA was associated with a lower risk of disability in older adults with sarcopenia, whereas MVPA was associated in subjects with robust and low physical function. Our findings indicate a need for individualized approaches to prevent disability based on muscle condition.
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影响因子：
3.7
作者：
Izawa KP;Shibata A;Ishii K;Miyawaki R;Oka K
通讯作者：
Oka K
影响因子：
6.7
作者：
Mijinarends, Donja M.;Koster, Annemarie;Harris, Tamara
通讯作者：
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DOI：
10.1007/s00198-017-3980-9
发表时间：
2017-06
期刊：
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
影响因子：
--
作者：
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通讯作者：
IOF-ESCEO Sarcopenia Working Group
影响因子：
3.9
作者：
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通讯作者：
Kelley, Kristi S.
影响因子：
4
作者：
Boo, Seung-Hyun;Joo, Min Cheol;Kim, Min-Su
通讯作者：
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