Grip strength and its determinants among older people in different healthcare settings
Grip strength and its determinants among older people in different healthcare settings
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DOI：
10.1093/ageing/aft118
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发表时间：
2014-03-01
期刊：
影响因子：
6.7
通讯作者：
Sayer, Avan Aihie
中科院分区：
文献类型：
--
作者：
Roberts, Helen C.;Syddall, Holly Emma;Sayer, Avan Aihie
背景：低肌力是老年综合征的核心，包括肌肉减少症和虚弱。在社区居住的老年人中已有很好的描述，但在康复或长期护理中老年人握力的流行病学研究却很少。目的：描述康复和疗养院中老年人的握力。设计：横断面流行病学研究。设置：一个城镇的三个医疗机构。受试者：方法：对101例康复病房住院患者、47例社区康复转诊患者和100例护理之家住院患者进行调查。握力、年龄、身高、体重、体重指数、合并症和药物治疗数量、Barthel评分、简易精神状态检查（MMSE），结果：男性和女性的握力在医疗机构之间存在显著差异（P < 0.0001）。疗养院居民有最低的年龄调整后的平均握力和社区康复转诊最高。单变量分析显示，更高的握力与更年轻、更高的身高和体重、更少的合并症、更高的Barthel评分、更高的MMSE评分、更好的营养状况和更少的福尔斯有关。然而，在对这些因素进行相互调整后，不同设置之间的握力差异仍然显着。Barthel评分的特点是最强烈相关的握力strengths.Conclusions：老年人在康复和护理之家的设置有较低的握力比那些生活在家里。此外，握力在不同的医疗机构之间变化很大，与已知的主要影响无关。需要进一步的研究来确定握力是否有助于识别在这些环境中有不良健康结果风险的人。
Background: low muscle strength is central to geriatric syndromes including sarcopenia and frailty. It is well described in community-dwelling older people, but the epidemiology of grip strength of older people in rehabilitation or long-term care has been little explored.Objective: to describe grip strength of older people in rehabilitation and nursing home settings.Design: cross-sectional epidemiological study.Setting: three healthcare settings in one town.Subjects: hundred and one inpatients on a rehabilitation ward, 47 community rehabilitation referrals and 100 nursing home residents.Methods: grip strength, age, height, weight, body mass index, number of co-morbidities and medications, Barthel score, Mini-Mental State Examination (MMSE), nutritional status and number of falls in the last year were recorded.Results: grip strength differed substantially between healthcare settings for both men and women (P < 0.0001). Nursing home residents had the lowest age-adjusted mean grip strength and community rehabilitation referrals the highest. Broadly higher grip strength was associated in univariate analyses with younger age, greater height and weight, fewer comorbidities, higher Barthel score, higher MMSE score, better nutritional status and fewer falls. However, after mutual adjustment for these factors, the difference in grip strength between settings remained significant. The Barthel score was the characteristic most strongly associated with grip strength.Conclusions: older people in rehabilitation and care home settings had lower grip strength than reported for those living at home. Furthermore grip strength varied widely between healthcare settings independent of known major influences. Further research is required to ascertain whether grip strength may help identify people at risk of adverse health outcomes within these settings.