Associations of Computed Tomography-Based Trunk Muscle Size and Density With Balance and Falls in Older Adults
Associations of Computed Tomography-Based Trunk Muscle Size and Density With Balance and Falls in Older Adults
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DOI：
10.1093/gerona/glv185
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发表时间：
2016-06-01
影响因子：
5.1
通讯作者：
Kiel, Douglas P.
中科院分区：
文献类型：
--
作者：
Anderson, Dennis E.;Quinn, Emily;Kiel, Douglas P.
平衡和肌肉功能的缺陷是老年人福尔斯跌倒的重要危险因素。衰老与肌肉大小和密度的显著下降有关，但躯干肌肉的大小和密度与老年人的平衡和福尔斯的关系以前没有被研究过。（横截面积）和衰减（组织密度的测量）在计算机断层扫描中测量（在L2腰椎水平）在一个队列的老年人（平均+/- SD年龄为81.9 +/- 6.4）居住在独立的生活社区。结果指标为基线时安静站立和短体力活动成套测验（SPPB）中测量的姿势摇摆，以及基线测量后参与者报告的长达3年的福尔斯。男性和女性中，较高的肌肉密度与减少的姿势摇摆（尤其是摇摆速度）相关，女性的短体力活动成套测验评分较好，但与福尔斯无关。男性和女性中，较大的肌肉尺寸与增加的姿势摇摆有关，并且与男性中跌倒的可能性增加有关。结果表明，平衡更多地取决于肌肉质量而不是肌肉的尺寸。意外的发现，较大的肌肉大小与增加姿势摇摆和增加跌倒风险相关，需要进一步调查，但强调了肌肉大小以外的因素在老年人肌肉功能中的重要性。
Deficits in balance and muscle function are important risk factors for falls in older adults. Aging is associated with significant declines in muscle size and density, but associations of trunk muscle size and density with balance and falls in older adults have not been previously examined.Trunk muscle size (cross-sectional area) and attenuation (a measure of tissue density) were measured in computed tomography scans (at the L2 lumbar level) in a cohort of older adults (mean +/- SD age of 81.9 +/- 6.4) residing in independent living communities. Outcome measures were postural sway measured during quiet standing and Short Physical Performance Battery (SPPB) at baseline, and falls reported by participants for up to 3 years after baseline measurements.Higher muscle density was associated with reduced postural sway, particularly sway velocities, in both men and women, and better Short Physical Performance Battery score in women, but was not associated with falls. Larger muscle size was associated with increased postural sway in men and women and with increased likelihood of falling in men.The results suggest that balance depends more on muscle quality than on the size of the muscle. The unexpected finding that larger muscle size was associated with increased postural sway and increased fall risk requires further investigation, but highlights the importance of factors besides muscle size in muscle function in older adults.