Heterogeneity in rate of decline in grip, hip, and knee strength and the risk of all-cause mortality: the Women's Health and Aging Study II.
Heterogeneity in rate of decline in grip, hip, and knee strength and the risk of all-cause mortality: the Women's Health and Aging Study II.
复制标题
抓地力，臀部和膝关节力量下降率的异质性以及全因死亡率的风险：妇女的健康和衰老研究II。
DOI：
10.1111/j.1532-5415.2010.03154.x
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发表时间：
2010-11
影响因子：
6.3
通讯作者：
Fried LP
中科院分区：
文献类型：
--
作者：
Xue QL;Beamer BA;Chaves PH;Guralnik JM;Fried LP
评估肌肉力量变化率与全因死亡率之间的关系。一项对身体残疾的原因和过程的前瞻性观察研究。马里兰州巴尔的摩市十二个相邻的邮政编码区域。研究基线为307名年龄在70-79岁的社区居住女性。结果是全因死亡率（1994-2009）；预测指标包括多达7项手部握力、膝关节伸展和髋屈曲强度的重复测量，中位随访时间为9年。在基线时评估人口统计学因素、体重指数、吸烟状况、慢性病数量、抑郁症状、体力活动、白细胞介素-6和白蛋白，并将其作为混杂因素。使用关节纵向和生存模型评估肌肉力量下降与死亡率之间的关系。握力和髋部力量在70 - 75岁期间平均每年下降1.10和1.31 kg，此后平均每年下降0.50和0.39 kg；膝关节强度以每年0.57 kg的恒定速率下降。握力、膝盖和臀部力量下降速度更快，而不是膝盖力量下降速度更快，在考虑其基线水平和潜在混杂因素后，独立预测死亡率(握力、膝盖和臀部力量下降速度每增加0.5个标准差，风险比（HR）分别为1.33（95%可信区间(CI)= 1.06-1.67）、1.14 （CI= 0.91-1.41）和2.62 （CI= 1.43-4.78）。除了绝对水平外，监测握力和髋屈曲强度下降的速度可以大大提高对死亡风险最高的妇女的识别。
To assess the relationship between rate of change in muscle strength and all-cause mortality. A prospective observational study of the causes and course of physical disability. Twelve contiguous ZIP code areas in Baltimore, Maryland. Three hundred and seven community-dwelling women aged 70–79 years at study baseline. The outcome is all-cause mortality (1994–2009); predictors include up to seven repeated measurements of handgrip, knee extension, and hip flexion strength, with a median follow-up time of 9 years. Demographic factors, body mass index, smoking status, number of chronic diseases, depressive symptoms, physical activity, Interlukin-6, and albumin were assessed at baseline and included as confounders. The associations between declining muscle strength and mortality were assessed using a joint longitudinal and survival model.. Grip and hip strength declined an average of 1.10 and 1.31 kg per year between age 70 and 75and 0.50 and 0.39 kg/year thereafter, respectively; knee strength declined at a constant rate of 0.57 kg/year. Faster rates of decline in grip and hip strength, but not knee strength, independently predicted of mortality after accounting for their baseline levels and potential confounders (Hazard Ratio (HR)=1.33 (95% confidence interval (CI)=1.06–1.67), 1.14 (CI=0.91–1.41), and 2.62 (CI=1.43–4.78) for every 0.5 standard deviation increase in rate of decline in grip, knee, and hip strength, respectively. Monitoring the rate of decline in grip and hip flexion strength in addition to the absolute levels may greatly improve the identification of women most at risk of dying.