Combined effect of lower muscle quality and quantity on incident falls and fall-related fractures in community-dwelling older adults: A 3-year follow-up study
Combined effect of lower muscle quality and quantity on incident falls and fall-related fractures in community-dwelling older adults: A 3-year follow-up study
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肌肉质量和数量较低对社区老年人跌倒和跌倒相关骨折的综合影响：一项为期 3 年的跟踪研究
DOI：
10.1016/j.bone.2022.116474
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发表时间：
2022
期刊：
影响因子：
4.1
通讯作者：
Arai Hidenori
中科院分区：
文献类型：
--
作者：
Yamada Minoru;Kimura Yosuke;Ishiyama Daisuke;Otobe Yuhei;Suzuki Mizue;Koyama Shingo;Arai Hidenori
目的：跌倒和骨折是世界范围内严重的老年人不良事件，骨骼肌被认为是这些事件的关键因素。本研究的目的是在为期3年的随访期中，研究低肌肉质量和低肌肉数量对社区老年人跌倒和跌倒相关骨折发生率的综合影响。方法：我们招募了2018年独立生活的65岁及以上社区居民。这项研究共分析了773名老年参与者。在3年的随访期间，结果是意外跌倒和跌倒相关骨折。在基线时，我们使用超声检查评估肌肉质量和数量，并根据肌肉质量差/较好和肌肉数量差/较好将参与者分为四组。采用Cox比例风险模型估计四组项目与意外跌倒和跌倒相关骨折发生时间之间关系的风险比（hr）和95%置信区间（ci）。结果在3年的随访期间，178名参与者（23.0%）发生跌倒事件，51名参与者（6.6%）发生跌倒相关骨折。根据多变量分析，以肌肉质量和数量较好的老年人为参照，肌肉质量和数量较低的老年人发生跌倒的风险显著增加（调整后的风险比：1.54 [95% CI 1.06-2.23]）。然而，四组之间在跌倒相关骨折方面没有显著差异。结论肌肉质量和数量越低，跌倒发生率越高；因此，识别肌肉质量和数量较低的社区居住老年人是必要的，可以为他们提供预防跌倒的措施，并可能减少跌倒相关的结果。
ObjectiveFalls and fractures are serious geriatric adverse events worldwide, and skeletal muscle is considered to be a key factor in these incidents. The objective of this study was to investigate the combined effect of lower muscle quality and quantity on the incidence of falls and fall-related fractures in a 3-year follow-up period among community-dwelling older adults.MethodsWe recruited community-dwelling adults aged 65 years and older who were living independently in 2018. A total of 773 older participants were analyzed in this study. The outcomes were incident falls and fall-related fractures during the 3-year follow-up period. At baseline, we assessed muscle quality and quantity using ultrasonography, and we categorized the participants into four groups based on their combination of poor/better muscle quality and poor/better muscle quantity. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of the relationships among items in the four groups and the time to incident falls and fall-related fractures.ResultsDuring the 3-year follow-up period, 178 participants (23.0 %) had a fall incident and 51 participants (6.6 %) had fall-related fractures. Older adults with lower muscle quality and quantity had significantly elevated risks of incident falls according to multivariate analyses using older adults with better muscle quality and quantity as the reference (adjusted HR: 1.54 [95 % CI 1.06–2.23]). However, there were no significant differences in fall-related fractures among the four groups.ConclusionWe found that lower muscle quality and quantity led to higher incidents of falls; thus, identifying community-dwelling older adults with lower muscle quality and quantity is necessary to provide them fall preventive measures and maybe to reduce fall-related outcomes.