Clinical Significance of Short-term Change and Variability of Grip Strength

握力短期变化和变异的临床意义

• 批准号: 8283048
• 负责人: Qian-Li Xue
• 金额: $ 8.1万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8283048
• 关键词: Address; Aging; Area; Biological Markers; Blood Pressure; Blood Vessels; Clinical; Clinical Trials; Data; Data Quality; Diagnosis; Distal; Elderly; Endocrine; Epidemiology; Event; Family; Future; Gait; Goals; Hand; Health; Health Status; Heterogeneity; Homeostasis; Hormones; Intervention; Intervention Studies; Knowledge; Link; Measurement; Measures; Muscle Weakness; Outcome; Patients; Performance; Persons; Phenotype; Physical Function; Physiological; Process; Relative (related person); Reporting; Risk; Risk Assessment; Risk Factors; Sampling; Sampling Studies; Skeletal Muscle; Speed; Statistical Methods; Statistical Models; Target Populations; Testing; Time; Visit; Woman; Women' s Health; Work; adverse outcome; age related; aged; base; biological systems; clinically relevant; clinically significant; design; disability; follow-up; frailty; grasp; improved; interest; middle age; mortality; muscle form; muscle strength; older women; pilot trial; prevent; prognostic; sarcopenia; stressor; success

DESCRIPTION (provided by applicant): Aging is associated with progressive lose of skeletal muscle mass and strength referred to as sarcopenia, a significant risk factor for disability, fraily, and mortality. Epidemiologically, muscle weakness defined based on a single measurement of hand grip strength has repeatedly proven to correlate with subsequent adverse health outcomes, even when measured in mid-life to predict physical disability decades later. These findings have led to ongoing efforts to define clinically meaningful cut points for muscle strength in the diagnosis of sarcopenia and growing interest in using grip strength as a key endpoint in clinical trials of new interventions for frailty. However, the success of such efforts requires improved knowledge in two areas. First, whether a single measurement of strength can sufficiently capture the underlying risk? Second, given that most of the pilot trials have a short follow-up, typically 6 months; it is important to know the degree and heterogeneity of detectable change in the short term and the clinical relevance of such change to long-term health outcomes. So far, these topics have not been adequately studied in a longitudinal setting. The central hypothesis is that short term trajectory of grip strength, characterized by rate of change and intra-person variability in grip strength, predicts long term trajectory of grip strength and adverse health outcomes in older adults. To test this hypothesis, this project proposes to evaluate: (i) the heterogeneity of short-term (6-month) trajectory of grip strength, (ii) the impac of short-term trajectory of grip strength on long-term (3- year) trajectories of health outcomes, and (iii) the effect of multisystem physiological dysregulation on short-term trajectory of grip strength. The study applies state-of-the-art statistical models to analyze existing longitudinal data from the Weekly Disability Substudy of the Women's Health and Aging Study (WHAS ) I. The substudy is comprised of 102 women aged 65 years and over who were evaluated on a weekly basis over six months, followed by additional five semi-annual visits of 6 months apart for a total follow-up of three years between 1993 and 1996. PUBLIC HEALTH RELEVANCE: This study is designed to break new grounds in understanding the clinical relevance of temporal changes in hand grip strength and their likely causes and consequences in older women. The results will provide useful risk assessment information to patients, families and clinicians, and preliminary data to define target population and treatment goals for future intervention studies on muscle strength in older adults.

描述(由申请人提供)：衰老与骨骼肌质量和力量的进行性丧失有关，称为骨质疏松症，这是导致残疾、虚弱和死亡的一个重要风险因素。在流行病学上，基于手握力的单一测量定义的肌肉无力已被反复证明与随后的不良健康后果相关，即使在中年测量时也是如此，以预测几十年后的身体残疾。这些发现导致了正在进行的确定具有临床意义的肌肉力量切割点的努力 在骨质疏松症的诊断方面，越来越多的人对使用握力作为治疗虚弱的新干预措施的临床试验的关键终点感兴趣。然而，这种努力的成功需要在两个领域提高知识。首先，单一的实力衡量标准是否足以捕捉潜在风险？其次，鉴于大多数试点试验的随访时间很短，通常为6个月；重要的是要了解短期内可检测到的变化的程度和异质性，以及这种变化与长期健康结果的临床相关性。到目前为止，这些主题还没有得到充分的纵向研究。中心假设是，握力的短期轨迹，以握力的变化率和人内变异性为特征，预测握力的长期轨迹和老年人的不良健康后果。为了验证这一假设，本项目建议评估：(I)握力短期轨迹(6个月)的异质性，(Ii)握力短期轨迹对长期(3年)健康结果轨迹的影响，以及(Iii)多系统生理失调对握力短期轨迹的影响。这项研究应用最先进的统计模型来分析妇女健康和老龄化研究(WHAS)I的每周残疾研究的现有纵向数据。这项研究包括102名65岁及以上的妇女，她们在6个月内每周接受评估，然后再进行5次半年一次的访问，间隔6个月，在1993至1996年间进行总共3年的跟踪调查。 公共卫生相关性：这项研究旨在为了解老年女性握力时间变化及其可能的原因和后果的临床相关性开辟新的基础。研究结果将为患者、家庭和临床医生提供有用的风险评估信息，并为未来老年人肌力干预研究确定目标人群和治疗目标提供初步数据。