Twelve-year sarcopenia trajectories in older adults: results from a population-based study.
Twelve-year sarcopenia trajectories in older adults: results from a population-based study.
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DOI：
10.1002/jcsm.12875
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发表时间：
2022-03
期刊：
影响因子：
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通讯作者：
Welmer AK
中科院分区：
文献类型：
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作者：
Trevisan C;Vetrano DL;Calvani R;Picca A;Welmer AK
肌肉减少症的动态性质，包括其不同阶段之间可能的过渡，目前尚不清楚。我们的目的是探索通过肌肉减少症阶段的12年过渡，并确定与老年人不同肌肉减少症轨迹相关的因素。我们纳入了来自SNAC-K研究的3219名参与者（年龄≥60岁，35.8%为男性，96.4%为社区居民）。在基线和长达12年时，未评估肌肉减少症（正常肌肉强度和质量）、可能的肌肉减少症（低肌肉强度和正常肌肉质量）和肌肉减少症（低肌肉强度和质量）。这些条件是根据EWGSOP 2标准的修改版本定义的，其中肌肉力量通过握力或椅子站立试验进行评价，肌肉质量来自小腿围。我们通过连续时间多阶段马尔可夫模型估计了1年、5年和10年的转移概率。用比例强度模型评估与不同转变可能性相关的社会人口统计学、生活方式和医学因素，并将相关性强度表示为风险比（HR）和95%置信区间（CI）。没有肌肉减少症的参与者10年发生可能的肌肉减少症和肌肉减少症的概率分别为17.1%和5.1%，没有过渡的概率为40.4%。可能患有肌肉减少症的患者5年内发生肌肉减少症（10.3%）和恢复为无肌肉减少症（10.7%）的几率相似。患有肌肉减少症的参与者有机会恢复到可能的肌肉减少症，范围从8.2%（5年）到4.7%（10年），10年后死亡的可能性为70.9%。年龄较大（HR = 1.11，95% CI：1.07-1.14），男性（HR = 1.84，95% CI：1.16-2.91），目前吸烟（HR = 1.84，95% CI：1.16-2.91），慢性疾病数量较多（HR = 1.07，95%CI：1.00-1.14）与肌肉减少症的发生相关，而较高水平的体力活动（HR = 1.84，95%CI：1.19-2.84）和认知功能（HR = 1.17，95%CI：1.05-1.31，简易精神状态检查每增加1分）与随后从可能的肌肉减少症到无肌肉减少症的较高逆转率相关（所有患者均P < 0.05）。没有探索的特征与肌肉减少症恢复到更健康的阶段相关。肌肉减少症似乎是一种动态状态，不同肌肉减少症阶段之间可能存在双向过渡，尤其是最早期。及时干预以改善身体和认知功能并更好地控制个人的慢性病可以帮助对抗肌肉减少症的进展。
The dynamic nature of sarcopenia, including possible transitions between its different stages, is currently unknown. We aimed to explore 12 year transitions through sarcopenia stages and identify factors associated with different sarcopenia trajectories in older adults. We included 3219 participants (aged ≥60 years, 35.8% men, 96.4% community‐dwelling) from the SNAC‐K study. No sarcopenia (normal muscle strength and mass), probable sarcopenia (low muscle strength and normal muscle mass), and sarcopenia (low muscle strength and mass) were assessed at baseline and up to 12 years. Such conditions were defined based on a modified version of the EWGSOP2 criteria with muscle strength evaluated through handgrip or chair stand tests, and muscle mass from calf circumference. We estimated 1, 5, and 10 year transition probabilities through continuous‐time multistage Markov modelling. Sociodemographic, lifestyle, and medical factors associated with the likelihood of different transitions were evaluated with proportional intensity models, and the associations' strength was expressed as hazard ratio (HR) and 95% confidence interval (CI). Participants with no sarcopenia had 10‐year probabilities of 17.1% and 5.1% to develop probable sarcopenia and sarcopenia, and a 40.4% chance of not transitioning. Those with probable sarcopenia had similar 5‐year chances of developing sarcopenia (10.3%) and reverting to no sarcopenia (10.7%). Participants with sarcopenia had chances to revert to probable sarcopenia ranging from 8.2% (at 5 years) to 4.7% (at 10 years), and a 70.9% chance of dying after 10 years. Older age (HR = 1.11, 95% CI: 1.07–1.14), male sex (HR = 1.84, 95% CI: 1.16–2.91), current smoking (HR = 1.84, 95% CI: 1.16–2.91), and higher number of chronic diseases (HR = 1.07, 95% CI: 1.00–1.14) were associated with sarcopenia development, while higher levels of physical activity (HR = 1.84, 95% CI: 1.19–2.84) and cognitive function (HR = 1.17, 95% CI: 1.05–1.31 per each 1‐point increase in the Mini‐Mental State Examination) were associated with subsequent higher reversion rates from probable sarcopenia to no sarcopenia (P < 0.05 for all). None of the explored characteristics were associated with sarcopenia reversion to healthier stages. Sarcopenia appears to be a dynamic condition with possible two‐way transitions between different sarcopenia stages, especially the earliest ones. Timely interventions to improve physical and cognitive function and better control individuals' chronic conditions could help counteract sarcopenia progression.