Prevalence of sarcopenia and associated factors in institutionalised older adult patients
Prevalence of sarcopenia and associated factors in institutionalised older adult patients
复制标题
DOI：
10.1016/j.clnesp.2018.05.008
复制
发表时间：
2018-10-01
影响因子：
3
通讯作者：
Navarro, Concepcion
中科院分区：
文献类型：
--
作者：
Bravo-Jose, Patricia;Moreno, Elena;Navarro, Concepcion
背景与目的：骨骼肌减少症是一种以骨骼肌质量和力量的进行性和广泛性丧失为特征的综合征，具有身体残疾、生活质量差和死亡等不良后果的风险。本研究的主要目的是利用ewgsop定义的标准确定长期护理机构中住院老年患者肌肉减少症的患病率。第二个目的是确定在这一人群中发生肌肉减少症的危险因素。方法：对334名住院老年患者进行了多中心横断面研究，测量了肌肉减少症的患病率及其与某些危险因素的关系。身体表现通过步态速度测量，肌肉力量通过手持式测功机测量，骨骼肌质量通过生物阻抗分析测量。收集了不同的变量：身体质量指数（BMI）、临床记录中的疾病、跌倒次数、活动水平和功能能力。结果：共纳入285人。根据EWGSOP算法和Masanes等人对西班牙人群提出的分界点，118名（41.4%）参与者出现肌肉减少症，其中32名（27%）患者患有中度肌肉减少症，78名（66%）患者被确定为重度肌肉减少症患者，只有8名（7%）患者被归类为肌肉减少性肥胖。更多的女性居民（96名女性（81.4%）对22名男性（18.6%），p < 0.0001）倾向于肌肉减少。诊断为肌肉减少症的患者往往比非肌肉减少症的患者功能受损更严重，BMI更不利（Barthel评分40.93比49.22,p = 0.0034, BMI 23.57比27.61,p < 0.0001）。回归分析结果显示，年龄大于85岁（OR 2.495, 95% CI 1.401 ~ 4.441）、女性（OR 3.215, 95% CI 1.635 ~ 6.324）、BMI < 22 （OR 5.973, 95% CI 2.932 ~ 12.165）与肌少症相关，而Barthel指数等因素与肌少症无关。结论：目前的研究表明，肌肉减少症在长期护理机构的患者中非常普遍，尤其是女性患者。我们的研究结果支持，肌肉质量与营养状况不良和日常生活基本活动能力差呈负相关，这表明这些患者高度依赖和高度需要护理。(c) 2018年欧洲临床营养与代谢学会。Elsevier Ltd.出版。版权所有。
Background & aims: Sarcopenia is a syndrome characterised by a progressive and generalised loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life and death. The main aim of the present study was to establish the prevalence of sarcopenia using EWGSOP-defined criteria in institutionalised older adult patients in long-term care institutions. A secondary purpose was to identify the risk factors that develop Sarcopenia in this population.Methods: A Multicentre cross-sectional study was conducted in 334 institutionalised older adult patients, where the prevalence of sarcopenia and its relation with certain risk factors were measured. Physical performance was measured by gait speed, muscle strength measured by a handheld dynamometer and skeletal muscle mass measured using bioimpedance analysis. Different variables were collected: body mass index (BMI), diseases documented in the clinical record, the numbers of falls, the level of activity and functional ability.Results: Two hundred eighty five individuals were included. According the EWGSOP algorithm and the cut-off points proposed by Masanes et al. for the Spanish population, 118 (41.4%) participants presented sarcopenia, of which 32 patients (27%) suffered from moderate sarcopenia, 78 patients (66%) were identified as severe sarcopenia patients and only 8 (7%) were classified as sarcopenic obesity. More female residents (96 females (81.4%) vs. 22 males (18.6%), p < 0.0001) tended to be sarcopenic. Patients diagnosed with sarcopenia tended to be more functionally impaired and had a more unfavourable BMI than those who were not sarcopenic (Barthel score 40.93 vs, 49.22, p = 0.0034 and BMI 23.57 vs, 27.61, p < 0.0001). Results from regression analysis indicated that those older than 85 years old (OR 2.495, 95% CI 1.401-4.441), the female gender, (OR 3.215, 95% CI 1.635-6.324) and whose BMI was lower than 22 (OR 5.973, 95% CI 2.932-12.165) appeared to be associated with sarcopenia, whereas the Barthel Index and other factors were not.Conclusion: The present study suggests that sarcopenia is highly prevalent in patients living in long-term care institutions, especially in female patients. Our findings support that the muscle mass was negatively associated with poor nutritional status and poor capacity to develop basic activities of daily living that indicates high dependency of these patients and high necessity of care. (c) 2018 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.