PHYSICAL FRAILTY IN OLDER ADULTS IS ASSOCIATED WITH METABOLIC AND ATHEROSCLEROTIC RISK FACTORS AND COGNITIVE IMPAIRMENT INDEPENDENT OF MUSCLE MASS
PHYSICAL FRAILTY IN OLDER ADULTS IS ASSOCIATED WITH METABOLIC AND ATHEROSCLEROTIC RISK FACTORS AND COGNITIVE IMPAIRMENT INDEPENDENT OF MUSCLE MASS
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DOI：
10.1007/s12603-011-0134-1
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发表时间：
2011-12-01
影响因子：
5.8
通讯作者：
Woo, J.
中科院分区：
文献类型：
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作者：
Lee, J. S. W.;Auyeung, T. -W.;Woo, J.
目的：代谢性和动脉粥样硬化性疾病是老年残疾的已知危险因素，并可导致肌肉减少症以及认知障碍，这两者都是虚弱综合征的组成部分。由于肌肉损失随着年龄的增长而增加，目前还不清楚肌肉损失本身或疾病本身是否是患有这些疾病的人身体虚弱的根本原因。我们检验了代谢性疾病、动脉粥样硬化性疾病和认知功能障碍与身体虚弱相关的假设，并进一步检验了它们对身体虚弱与死亡率之间关系的影响。设计：前瞻性。设置：社区。研究对象：4000名65岁以上的社区老年人。测量值：记录糖尿病、高血压、中风、心脏病、认知功能障碍、吸烟、体力活动、腰臀比（WHR）和踝臂指数（ABI）。根据表现的四分位数，将身体虚弱测量（握力、椅子站立、步幅和6米步行）总结为复合虚弱评分（0-20），0为最虚弱）。采用双能X线吸收法测量肩胛肌质量（ASM）。分析评分和协变量之间的关系。采用考克斯回归研究代谢和神经衰弱危险因素对体质虚弱和6年死亡率之间关系的影响。结果如下：校正ASM后，单因素分析显示，所有代谢性疾病和指标以及认知功能障碍与综合身体虚弱评分显著相关。在多变量分析中，认知功能障碍，高腰臀比，糖尿病，中风和心脏病都与较高的身体虚弱与年龄，体力活动水平和ASM调整独立相关。高血压与男性身体虚弱有关，但与女性无关。在考克斯回归分析中，身体虚弱程度的增加与6年死亡率的增加相关。然而，在调整年龄和认知功能后，代谢和动脉粥样硬化危险因素的影响是适度的。结论：代谢性疾病、动脉粥样硬化性疾病和高腰臀比与身体虚弱相关，与认知功能和肌肉质量的不良影响无关。
Objective: Metabolic and atherosclerotic diseases are known risk factors for disability in old age, and can result in sarcopenia as well as cognitive impairment, which are both components of frailty syndrome. As muscle loss increases with ageing, it is unclear whether muscle loss per se, or the diseases themselves, are the underlying cause of physical frailty in those suffering from these diseases. We tested the hypothesis that metabolic and atherosclerotic diseases and cognitive impairment are associated with physical frailty independent of muscle loss in old age, and further examined their impact on the relationship between physical frailty and mortality. Design: Prospective. Setting: Community. Participants: 4000 community dwelling Chinese elderly >= 65 years. Measurements: Diabetes, hypertension, stroke, heart disease, cognitive impairment, smoking, physical activity, waist hip ratio (WHR) and ankle-brachial index (ABI)) were recorded. Physical frailty measurements (grip-strength, chair-stands, stride length and 6-metre walks) were summarized into a composite frailty score (0-20), 0 being the most frail) according to quartiles of performance. Appendicular muscle mass (ASM) was measured using dual X-ray absorptiometry. Relationships between the score and covariates were analyzed. Cox regression was used to study the impact of metabolic and atnerosclerotic risk factors on the relationship between physical frailty and 6-year mortality. Results: After adjustment for ASM, all metabolic diseases and indexes, and cognitive impairment were significantly associated with the composite physical frailty score in univariate analysis. In multivariate analysis, cognitive impairment, high WHR, diabetes, stroke and heart disease were all independently associated with higher physical frailty with adjustment for age, physical activity level and ASM. Hypertension was associated with physical frailty in men but not in women. In Cox regression, increased physical frailty was associated with higher 6-year mortality. The impact of metabolic and atherosclerotic risk factors was however only modest after adjustment for age and cognitive function. Conclusion: Metabolic and atherosclerotic diseases and high WHR, was associated with physical frailty, independent of their adverse effect on cognitive function and muscle mass.