Nonpharmacological interventions to treat physical frailty and sarcopenia in older patients: a systematic overview - the SENATOR Project ONTOP Series.
Nonpharmacological interventions to treat physical frailty and sarcopenia in older patients: a systematic overview - the SENATOR Project ONTOP Series.
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治疗老年患者身体虚弱和骨质疏松症的非药物干预：系统性综述--参议员计划ONTOP系列。
DOI：
10.2147/cia.s132496
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发表时间：
2017
影响因子：
3.6
通讯作者：
Cruz-Jentoft AJ
中科院分区：
文献类型：
--
作者：
Lozano-Montoya I;Correa-Pérez A;Abraha I;Soiza RL;Cherubini A;O'Mahony D;Cruz-Jentoft AJ
身体虚弱（PF）和肌肉减少症是负面健康结果的预测因子，如福尔斯、残疾、住院和死亡。已经发表了一些关于虚弱和肌肉减少症的不同非药物治疗的系统综述（SR），使用了不同的定义。批判性评价来自非药物干预治疗老年患者PF（根据Fried虚弱表型定义）和肌肉减少症（根据EWGSOP定义）的主要研究SR的证据。SR概述和比较研究的荟萃分析。2015年10月检索了PubMed、科克伦系统综述数据库、EMBASE和CINAHL。SR包括至少一项比较研究，评价在任何医疗保健环境中治疗老年患者PF或肌肉减少症的任何非药物干预。纳入了这些SR中描述的具有实验设计的任何主要研究。两名评审员独立筛选文章的标题、摘要和全文。使用科克伦协作组和GRADE工作组的标准进行质量评估。5项主要研究的10份SR符合入选标准。纳入研究中最常见的干预措施是体育锻炼（4）和营养补充（2）。肌肉力量（MS;除了在虚弱人群中的一项研究之外）和身体表现（PP;除了在虚弱人群中的另一项研究之外）在虚弱和肌肉减少的老年人中通过运动和氨基酸补充而改善。在两项研究中评估了福尔斯和日常生活活动，结果相反。证据的总体质量很低。SR的这一概述强调了运动干预（有或没有营养补充）对改善年龄>65岁的PF和肌肉减少症社区居民患者PP的重要性。在这一人群中，MS通过多学科治疗和运动干预得到改善。
Physical frailty (PF) and sarcopenia are predictors of negative health outcomes such as falls, disability, hospitalization, and death. Some systematic reviews (SRs) have been published on different nonpharmacological treatments of frailty and sarcopenia using heterogeneous definitions of them. To critically appraise the evidence from SRs of the primary studies on nonpharmacological interventions to treat PF (defined by Fried’s frailty phenotype) and sarcopenia (defined by the EWGSOP) in older patients. Overview of SRs and meta-analysis of comparative studies. PubMed, Cochrane Database of Systematic Reviews, EMBASE, and CINAHL were searched in October 2015. SRs that included at least one comparative study evaluating any nonpharmacological intervention to treat PF or sarcopenia in older patients in any health care setting. Any primary study described in these SRs with experimental design was included. Two reviewers independently screened titles, abstracts, and full-texts of articles. Quality assessment was carried out by using criteria from the Cochrane Collaboration and the GRADE working group. Ten SRs with 5 primary studies satisfied the inclusion criteria. The most frequent interventions in the included studies were physical exercise (4) and nutritional supplementation (2). Muscle strength (MS; except for one study in a frail population) and physical performance (PP; except for another study in a frail population) improved with exercise and amino acid supplementation in frail and sarcopenic old adults. Falls and activities of daily living were assessed in two studies with opposite results. The overall quality of the evidence was low. This overview of SRs highlights the importance of exercise interventions with or without nutritional supplementation to improve the PP in community-dwelling patients aged >65 years with PF and sarcopenia. MS improved with multidisciplinary treatment and exercise interventions in this population.