Individual and joint trajectories of change in bone, lean mass and physical performance in older men
Individual and joint trajectories of change in bone, lean mass and physical performance in older men
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DOI：
10.1186/s12877-020-01560-5
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发表时间：
2020-05-05
期刊：
影响因子：
4.1
通讯作者：
Orwoll, Eric S.
中科院分区：
文献类型：
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作者：
Cawthon, Peggy M.;Parimi, Neeta;Orwoll, Eric S.
背景：老年人骨骼、肌肉和身体机能的下降与不良健康结果有关。然而，很少有研究描述了这些因素中与年龄相关的变化模式。本研究的目的是在一项前瞻性队列研究中描述老年男性肌肉、体能和骨骼的四个特性的变化。方法对4681名男性（平均基线年龄72.7岁）进行长达6.9年的4次随访，并使用重复的纵向数据。+/- 5.3)参与男性骨质疏松性骨折（MrOS）研究，我们使用基于组的轨迹模型（SAS中的PROC TRAJ）来识别肌肉、体能和骨骼的四个特性的年龄相关变化模式：通过DXA，髋部总骨矿物质（BMD）密度（g/m(2)）和阑尾瘦质量/ht(2) (kg/m(2))；握力（kg），手测力；步行速度（m/s），按平时步行速度超过6 m计算。我们还描述了这些测量的所有成对组合的联合轨迹。每个轨迹放置的平均后验概率（或潜在组的联合隶属度）用于评估模型的内部可靠性。每个单独因素的轨迹数量被限制为三个，以确保联合轨迹的成对确定将产生可处理的组数量以及模型拟合考虑。结果：所有措施的变化模式大致相似，三个地区群体随着时间的推移以大致相似的速度下降；联合轨迹显示出相似的模式，在群体之间没有交叉或收敛。所有轨迹的平均后验概率相似且始终高于0.8，表明模型与数据的拟合合理。我们对骨密度、握力、步行速度和阑尾瘦质量随年龄变化轨迹的描述发现，即使考虑到这些因素的关节变化轨迹，通过这些方法识别的群体也几乎没有随年龄变化的交叉或收敛。
Background Declines in bone, muscle and physical performance are associated with adverse health outcomes in older adults. However, few studies have described concurrent age-related patterns of change in these factors. The purpose of this study was to characterize change in four properties of muscle, physical performance, and bone in a prospective cohort study of older men. Methods Using repeated longitudinal data from up to four visits across 6.9 years from up to 4681 men (mean age at baseline 72.7 yrs. +/- 5.3) participating in the Osteoporotic Fractures in Men (MrOS) Study, we used group-based trajectory models (PROC TRAJ in SAS) to identify age-related patterns of change in four properties of muscle, physical performance, and bone: total hip bone mineral (BMD) density (g/m(2)) and appendicular lean mass/ht(2) (kg/m(2)), by DXA; grip strength (kg), by hand dynamometry; and walking speed (m/s), by usual walking pace over 6 m. We also described joint trajectories in all pair-wise combinations of these measures. Mean posterior probabilities of placement in each trajectory (or joint membership in latent groups) were used to assess internal reliability of the model. The number of trajectories for each individual factor was limited to three, to ensure that the pair-wise determination of joint trajectories would yield a tractable number of groups as well as model fit considerations. Results The patterns of change identified were generally similar for all measures, with three district groups declining over time at roughly similar rates; joint trajectories revealed similar patterns with no cross-over or convergence between groups. Mean posterior probabilities for all trajectories were similar and consistently above 0.8 indicating reasonable model fit to the data. Conclusions Our description of trajectories of change with age in bone mineral density, grip strength, walking speed and appendicular lean mass found that groups identified by these methods appeared to have little crossover or convergence of change with age, even when considering joint trajectories of change in these factors.