Frailty and cardiovascular disease： potential role of gait speed in surgical risk stratification in older adults

Frailty is a state of late life decline and vulnerability, typified by physical weakness and decreased physiologic reserve. The epidemiology and pathophysiology of frailty share features with those of cardiovascular disease. Gait speed can be used as a measure of frailty and is a powerful predictor of mortality. Advancing age is a potent risk factor for cardiovascular disease and has been associated with an increased risk of adverse outcomes. Older adults comprise approximately half of cardiac surgery patients, and account for nearly 80% of the major complications and deaths following surgery. The ability of traditional risk models to predict mortality and major morbidity in older patients being considered for cardiac surgery may improve if frailty, as measured by gait speed, is included in their assessment. It is possible that in the future frailty assessment may assist in choosing among therapies （e.g., surgical vs. percutaneous aortic valve replacement for patients with aortic stenosis）.

Gait speed and hospitalization among ambulatory hemodialysis patients: USRDS special study data

AIM： To assess the association of measured gait speed with hemodialysis （HD） patients’ hospitalization, in conjunction with, and apart from, recent fall history.METHODS： Gait speed was measured by a standard protocol and falls during the past 12 mo were ascertained for a prevalent multi-center HD cohort （n = 668） aged 20-92. Hospitalization during the past 12 mo was identified in the patient’s clinic records, and the first hospitalization after gait speed assessment （or the competing event of death） was identifed in the 2013 United States Renal Data System Standard Analysis Files.characterized 34.7% of the patients, and 27.1% had experienced a recent fall. Patients with slow gait speed but without a history of recent falls were 1.79 times more likely to have been hospitalized during the past 12 mo （OR = 1.79, 95%CI： 1.11-2.88, P = 0.02）, and patients with slow gait speed and a history of recent falls were over two times more likely to have been hospitalized （OR = 2.10, 95%CI： 1.19-3.73, P = 0.01）, compared with patients having faster gait speed and no recent fall history. Prospective examination of gait speed/fall history status in relation to frst hospitaliza-tion （or death） incurred by the end of follow-up Decem-ber 31, 2011 also showed that slow gait speed was as-sociated with these events in conjunction with a history of falls （HR = 1.54, 95%CI： 1.04-2.30, P = 0.03）.CONCLUSION： The International Task Force on Nutri-tion and Aging reported that gait speed is a powerful predictor for older adults of adverse outcomes such as hospitalization. In our data, gait speed-apart from, as well as in conjunction with, recent fall history-was as-sociated with HD patients’ hospitalization for multiple causes. Gait speed may be a sensitive health indicator among HD patients across the age spectrum.

The minimal clinically important difference for gait speed in significant unilateral vestibular hypofunction after vestibular rehabilitation

Gait speed is a valid measure of both physical function and vestibular health.Vestibular rehabilitation is useful to improve gait speed for patients with vestibular hypofunction,yet there is little data to indicate how changes in gait speed reflect changes in patient-reported health outcomes.We determined the minimal clinically important difference in the gait speed of patients with unilateral vestibular hypofunction,mostly due to deafferentation surgery,as anchored to the Dizziness Handicap Index and the Activities Balance Confidence scale,validated using regression analysis,change difference,receiveroperator characteristic curve,and average change methods.After six weeks of vestibular rehabilitation,a change in gait speed from 0.20 to 0.34 m/s with 95%confidence was required for the patients to perceive a significant reduction in perception of dizziness and improved balance confidence.

Correlations between Motor Ability with Gait Speed and Cognitive Functions in Rehabilitation Users

Purpose: To compare and examine motor and cognitive functions in people who require support, and in healthy elders. Method: The variables of age, BMI, educational background, blood pressure, grip strength, knee extension, gait speed, MMSE, and subjective health feeling for 36 rehabilitation users and 22 healthy elders were assessed. We compared and examined motor and cognitive functions in rehabilitation users who need support and healthy elders. Results: The percentage of MMSE scores with 27 points or higher and that of subjective health feeling with 3 points or higher were significantly higher in healthy elders than in rehabilitation users. Systolic and diastolic blood pressure were significantly higher in rehabilitation users than in healthy elders. Gait speed and MMSE scores were significantly higher in healthy elders than rehabilitation users. Conclusion: Gait speed could be used for physical fitness in elders. Gait speed was the best physical fitness measurement for elders. Gait speed of rehabilitation users was strongly related to MMSE scores. Gait speed could be a determinant of MMSE scores.

In Community Dwelling Females Age 65 or Older, Gait Speed Declines as Kinesthetic Awareness of the Lower Legs Decreases

Purpose: This study investigates the existence of a correlation between the gait speed and kinesthetic sense in lower legs and to conduct further analysis of kinesthetic sense in relation to the risk of fall among community dwelling females aged 65 years or older. Materials and Methods: A non-experimental correlational, descriptive, and cohort study included 38 community dwelling females (average age of 82.5 years). The kinesthetic ruler (K-Ruler) and kinesthetic test protocol were created and used to assess lower extremity kinesthetic awareness. The GaitRite System was used to assess gait speed. Each subject was categorized into four groups: “LL” (Low K-Score and low gait speed), “LH” (Low K-Score and high gait speed), “HL” (High K-Score and low gait speed), and “HH” (High K-Score and high gait speed) according to kinesthetic awareness and gait speed measured. Voluntary fall incidence reporting over the 6-month period was followed by the initial data collection. Results: Pearson product-moment correlation (2-tailed) showed that there is a statistically significant, positive moderate-to-strong correlation between K-score and gait speed (ICC = 0.692, p Discussion: Gait speed declines as kinesthetic awareness of lower extremity decreases in community dwelling 65 or older female subjects. Additionally, the combination of kinesthetic awareness and gait speed can be served as a predictor of fall risk. The K-ruler can be used to assess lower extremity kinesthetic awareness in older people as a feasible and standard test.

Gait speed may predict development of Type 2 diabetes: A pilot study among elderly Japanese

Aims: Epidemiologic evidence suggests that physical activity is associated with reduced risk of Type 2 diabetes. Walking is simple, effective, and by far the most prevalent physical activity among older adults. However, it is difficult to recognize and evaluate performance-based parameters of physical activity. The purpose of this study was to evaluate the importance of performance-based gait speed among several physical measurements in the development of Type 2 diabetes using long-term community-based data on elderly Japanese persons. Methods: 10 baseline physical measurements, including habitual (HGS) and fast (FGS) gait speed, were examined in 102 elderly Japanese persons living independently in the community (mean age: 71.1 years old) who were not previously diagnosed with diabetes. The subjects then participated in a daily exercise program consisting of walking, stretching, muscle strengthening, and balance exercises and were followed for an average of 4.16 years. Using Cox proportional hazards models with adjustment for age, sex, and category of fasting glucose status, we investigated whether gait speed and/or other physical measurements are associated with development of Type 2 diabetes. Results: 9 subjects developed Type 2 diabetes. Among the 10 physical parameters examined, prolongation of HGS and FGS per second was the only statistically significant factors, with hazard ratios 1.83 (1.15 - 2.89, P = 0.010) and 2.93 (1.43 - 6.03, P = 0.003), respectively. Conclusions: We found a negative association between the development of Type 2 diabetes and gait speed among elderly Japanese people. We conclude that encouraging physical activity and preserving walking capacity may be beneficial for preventing Type 2 diabetes.

Should gait speed be included in the clinical evaluation of Parkinson’s disease?

Background: The Unified Parkinson’s Disease Rating Scale is the most commonly used scale in the clinical study of Parkinson’s disease. However, it may fail to capture the essence of physical impairment in patients with Parkinson’s disease and thus limit responsiveness of care-givers, patients, and/or clinicians as to increasing physical disability. This study sought to compare subjective measures of physical disability in Parkinson’s disease to an objective, accurate, and proven measure of physical function-gait speed. Methods: Eighty-eight individuals with early to moderate stage Parkinson’s disease were evaluated on the Unified Parkinson’s Disease Rating Scale, the Parkinson’s disease Questionnaire 39 and during five 8 meter walking trials. Spearman correlations coefficients were used to determine the association among all variables of interest. Results: The findings demonstrate that only a fair to moderate relationship between objectively measured gait speed and physical function as measured subjectively by the clinical rating scale and as evaluated by the patients during self report. Conclusions: The results of this study suggest that commonly utilized measures of physical function in Parkinson’s disease are not highly correlated with gait speed. Because gait speed is demonstrated as a dependable proxy for physical function, the results of this study may provide a rational for the use of gait speed to provide a more accurate picture of physical function in patients with Parkinson’s disease.

全膝关节置换前膝关节伸屈肌肌肉力量与置换后步态功能的关系

背景:步态功能障碍是导致全膝关节置换后患者不满的重要原因之一,临床研究中发现术前股四头肌和腘绳肌的肌肉力量与术后步态功能障碍有关,但其相关性目前尚不完全清楚。目的:探讨全膝关节置换前以股四头肌为主的伸肌、以腘绳肌为主的屈肌肌肉力量与置换后步态功能等的相关性。方法:回顾性分析70例接受单侧初次全膝关节置换患者的纵向数据,术前测量伸屈肌的峰力矩、峰力矩体质量比、总功数据,术后6个月测量起立-步行计时测试结果和步态速度。使用岭回归分析确定术后步态功能的影响因素。结果与结论:①术前伸肌峰力矩、峰力矩体质量比、总功以及屈肌峰力矩、总功与术后步态速度呈非常强正相关(P<0.001),术前屈肌峰力矩体质量比与术后步态速度呈强正相关(P<0.001);术前伸肌、屈肌峰力矩、峰力矩体质量比、总功与术后起立-步行计时测试结果呈非常强负相关(P<0.001);②岭回归分析中,94.2%可能性可说明术前伸肌峰力矩、峰力矩体质量比、总功及屈肌峰力矩、总功对全膝关节置换后患者的步态速度具有正向影响(P<0.001),术前屈肌峰力矩体质量比对术后步态速度具有负向影响(P<0.001);87.7%可能性说明术前伸肌峰力矩、峰力矩体质量比、总功及屈肌峰力矩、总功对术后起立-步行计时测试具有负向影响(P<0.05),而屈肌峰力矩体质量比对术后起立-步行计时测试无影响(P>0.05);③提示全膝关节置换前股四头肌、腘绳肌肌肉力量的大小与置换后步态速度、起立-步行计时测试结果相关,可预测术后步态功能结果;加强置换前膝关节肌肉锻炼可能是减缓全膝关节置换后步态障碍发生的途径。

相位角与肌少症及相关诊断指标的Meta分析

目的:系统评价相位角与肌少症及相关诊断指标的相关性。方法:计算机检索PubMed、EMbase、Cochrane Library、Web of Science、中国知网、万方、维普和SinoMed数据库,收集关于相位角与肌少症及相关诊断指标相关的临床研究,检索时限均为各数据库建库至2024-05-08。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险。采用RevMan 5.3和Stata 14.0软件进行Meta分析。结果:经筛选共纳入50篇合格文献。Meta分析结果显示,与非肌少症人群对比,肌少症患者的相位角显著降低[SMD=-0.99,95%CI(-1.09,-0.90),P<0.00001]。亚组分析结果表明,重度肌少症以及亚洲肌少症患者相位角差值更加显著,并且伴有肌少症的恶性肿瘤和呼吸系统疾病患者的相位角降低更加明显。相位角与骨骼肌质量指数(Pearson’s r=0.565,P<0.00001)、握力(Pearson’s r=0.446,P<0.00001)、步速(Pearson’s r=0.405,P<0.00001)均呈中等正相关,但与四肢骨骼肌质量指数呈极弱正相关(Pearson’s r=0.139,P=0.02)。结论:与非肌少症人群对比,相位角在肌少症人群具有显著差异性,且与肌少症诊断指标均存在不同程度相关性,提示相位角在肌少症的客观诊断中具有一定的临床价值,但其结果可能受到肌少症严重程度、相位角检测仪器等因素的影响,且因受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。

北京社区55~75岁高、低痴呆风险人群身体素质及其认知功能特点

目的分析预测社区中处于生命中期健康老年人痴呆风险因素。方法2021年7月至2023年4月招募北京市两个社区常住1年以上的55~75岁中老年人175例,收集心血管危险因素、衰老和痴呆(CAIDE)相关危险因素和其他一般人口资料,CAIDE风险评分≥9分为高危组,<9分为低危组。采用Stroop色词测验(SCWT)、两元素1-back任务范式、连线测验(TMT)进行评估;测量握力、30 s前臂屈曲测验和5次坐站试验;记录平地步行10 m的平均步速和步长。结果高危组CAIDE总分平均9.86分,低危组4.95分。两组年龄无显著性差异(P=0.188)。男性,受教育程度<7年、收缩压>140 mmHg、胆固醇>6.5 mmol/L、体质量指数>30 kg/m^(2)和缺乏体力活动人群CAIDE痴呆风险评分更高(χ^(2)>3.116,P<0.05)。高危组握力(t=-4.174)、步速(t=-2.414)、SCWT正确率(Z=-2.684)均差于低危组(P<0.05)。Logistic回归分析显示,步速(OR=25.483)、握力(OR=1.133),SCWT正确率(OR=37.430)是痴呆的独立危险因素(P<0.05)。结论握力弱、步速慢、抑制控制能力差可能预示痴呆风险增加。

“补肾活血”方改善脑小血管病患者信息处理速度

目的:探讨“补肾活血”方改善脑小血管病轻度认知障碍患者信息处理速度的临床研究。方法:选取符合标准的176例“肾精亏虚合瘀血阻络型”脑小血管病轻度认知功能障碍患者,分为治疗组91例和对照组85例。治疗组患者接受补肾活血中药治疗3个月,2组患者均随访1年;比较2组患者整体认知、信息处理速度和步态变化。结果:2组患者年龄、性别、教育水平均无统计学差异。经3个月治疗,中药组患者认知整体水平较前升高,连线试验、步态试验完成时间较前缩短(P<0.05)。随访1年,中药组患者认知整体水平较治疗前稍有提高(P<0.05);对照组患者在连线试验完成时间、步态测试完成时间均较中药组延长(P<0.05)。结论:补肾活血治疗可改善患者整体认知功能及信息处理速度,并且延缓患者1年信息处理速度下降程度。

老年人工具性生活活动能力水平与常速行走步态特征的关联分析

目的探讨老年人常速行走下步态参数特征及其与工具性生活活动能力(instrumental activity of daily living,IADL)水平的关系。方法2023年2-8月,应用方便抽样,选取北京医院60岁及以上自愿接受调查的老年人为研究对象进行横断面调查,收集研究对象的一般特征资料,采用IADL量表评估IADL水平,依据IADL是否受损将研究对象分为两组,使用多传感器可穿戴步态分析仪IDEEA采集研究对象常速行走状况下的步态参数。采用多因素Logistic回归模型分析老年人常速行走下步态参数与IADL受损发生风险的关联。结果共739例纳入研究,受损组293例,正常组446例。与正常组比较,受损组老年人时空步态参数如步速、步频和步长等降低,动力学参数如大腿摆动功、地面冲击力和脚离地角度降低,步态周期参数如单脚支撑时间等增加,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,步频、步长、跨步长、足落地控制和脚离地角度与IADL受损存在关联(P<0.05)。年龄分层分析中,≥70岁老年人群步态特征与IADL受损发生风险呈现更为显著的相关性(P<0.05)。结论IADL受损老年人步态性能下降,时空步态参数与动力学参数与老年人IADL受损关系密切。

不同脑网络经颅直流电刺激方案对健康成年人步态特征的特异性调控效果研究

目的:基于额顶网络(FPN)、背侧注意网络(DAN)、默认网络(DN)三个步态相关脑网络,制定不同的脑网络经颅直流电刺激(Network t DCS)方案以期实现特异性调控步速和步态变异性、提高步行功能的目的。方法:本研究招募健康成年人,随机分3组,分别接受不同的刺激方案:兴奋FPN抑制DN(FPN+/DN-t DCS)、兴奋DAN抑制DN(DAN+/DN-t DCS)、假刺激(Sham)。在刺激前和刺激后即刻进行常速、快速和双任务条件的步态任务测试。采用双因素重复测量方差分析评估三种刺激方案对不同条件下的步态时空参数和步态变异性的影响。结果:本研究共纳入72例受试者,其中64例完成测试。干预前后常速、快速和双任务步行条件下步态时空参数指标和常速步行条件下步态变异性的改变均无显著交互效应。快速步态任务中,步幅变异性(F=3.671,P=0.031)和双支撑时间变异性(F=3.879,P=0.026)存在显著交互效应;双任务步行条件下,步宽变异性(F=3.940,P=0.025)、步速变异性(F=3.936,P=0.025)和双支撑时间变异性(F=4.913,P=0.011)存在交互效应。结论:DAN+/DN-t DCS可有效降低健康成年人复杂任务的步态变异性、提升步态稳定性;但FPN+/DN-t DCS方案并未特异性提升不同条件下的步速水平。

中国老年人握力和步速与衰弱关系的研究

目的 探索中国老年人握力和步速与衰弱间的关系,探寻握力与步速的预警值。方法 基于中国健康与养老追踪调查2011—2015年数据,纳入9 271名年龄≥60岁的老年人。本研究构建衰弱指数,采用广义估计方程结合限制性立方样条分析握力和步速与衰弱之间的关系,采用分段线性回归分别识别握力和步速与衰弱关联的转折点,以转折点为预警值将握力和步速分为低值组和正常组,采用线性回归和多分类逻辑回归的广义估计方程分析握力和步速组合与衰弱之间的关联。结果 衰弱指数随着握力和步速增大逐渐减小,且在握力和步速较低时减小幅度较大,较高时变缓。男性体重标化握力和步速的预警值分别为0.60 kg/kg和0.60 m/s,女性分别为0.47 kg/kg和0.66 m/s。与正常握力和正常步速相比,低握力和低步速组合与更高的衰弱风险相关。结论 中国老年人群的握力和步速与衰弱间均呈非线性负向关联。握力和步速的预警值能够快速识别衰弱高风险人群。

基于智能可穿戴设备的步态与速度的实证研究

目的:建立基于智能可穿戴设备的速度预测模型,为运动员的训练提供参考.方法:使用SPSS对8名天水师范学院体育学院田径专项学生的步态数据进行了Pearson相关性检验和逐步回归分析.结果:坡度与前掌着地比例、平均步幅之间有着显著的正相关关系(P<0.01),与脚跟着地比例之间呈显著的负相关关系(P<0.01),与外翻幅度之间呈显著的负相关关系(P<0.05);速度与活动卡路里、步数、前掌着地比例、平均步频、平均步幅、平均腾空时间、平均触地腾空比、平均着地冲击力之间呈显著的正相关关系(P<0.01);与全掌着地比例、脚跟着地比例、平均触地时间之间呈显著的负相关关系(P<0.01).结论与建议:智能可穿戴设备的跑步豆功能算法整体的平均准确率较高,所采集的数据在训练过程中对运动员具有一定的指导作用.建议CyweeMotion公司利用软件算法和六轴运动传感器实时捕捉的数据增加摆动角度的App端的可读数字,为改善跑者大小腿折叠技术提供一定的参考,提高跑步效率.

正常成人步态特征研究

目的 研究不同年龄段正常成人的步态特征。方法正常成人90名，分为20～39岁组、40～59岁组、60～70岁组，每组各30名。应用基于数字视频和图像处理的步态分析系统进行步态分析，得到时夺参数、运动学参数。比较3组被试的步态参数差异，对步速与其他步态参数进行Pearson相关性分析，以判定影响步速的相关因素。结果 3组正常成人的部分步忿参数之间存在显著性差异，步速与步频、跨步长／身高、跨步周期、站立相时间、迈步相髋关节、膝关节最大屈曲角度有明娃相关性。结论 应用基于数字视频和图像处理的步态分析系统建立的国内不同年龄段正常成人步态的运动学特征模型，可供临床步态分析参考使用。

脑卒中偏瘫患者下肢痉挛与步行速度的关系

目的探讨脑卒中偏瘫患者下肢痉挛与步行速度之间的关系。方法对 3 5例脑卒中偏瘫痉挛患者用改良Ashworth法评定下肢膝伸肌和足跖屈肌的痉挛程度 ;测定步行速度、步距和步频 ;分析膝伸肌和足跖屈肌痉挛与步行速度、步长和步频之间的相关性 ,以及决定步行速度、步长和步频的下肢痉挛因素。结果患者在自由步行时的步行速度与膝伸肌和足跖屈肌痉挛呈中度负相关 (r =-0 .43 2 ,P <0 .0 5 ;r =-0 .44 8,P <0 .0 5 ) ,其中膝伸肌痉挛仅与步频呈中度负相关 (r =-0 .415 ,P <0 .0 5 ) ,而足跖屈肌痉挛与步距和步频呈中度负相关 (r =-0 .41,P <0 .0 5 ;r =-0 .3 3 5 ,P <0 .0 5 )。最大步行速度时的步长和步频与膝伸肌和足跖屈肌痉挛之间无相关性 (r =-0 .118— 0 .3 0 7,P >0 .0 5 )。决定自由步行速度、步长的下肢痉挛因素是足跖屈肌痉挛 (分别为R2 =0 .2 0 ,P <0 .0 1;R2 =0 .168,P <0 .0 5 ) ;决定步频的是膝伸肌痉挛 (R2 =0 .172 ,P <0 .0 5 )。结论脑卒中偏瘫患者下肢痉挛对步行速度的影响力较小 ,在以改善患者步行能力为目的的治疗中 ,应重点关注痉挛以外的其他更重要的临床因素。

老年人下肢肌力和功能性活动测试与步速的相关性

目的了解老年人下肢特殊肌群肌力和几种功能性活动测试与步速的相关性。方法 341名居家老年人（65~94岁）,按步速〈0.8 m/s为肌少症的筛查标准,分为可疑肌少症组（n=137）和正常组（n=204）。比较两组人群的基本特征,下肢肌群（包括髂腰肌、股四头肌、腘绳肌、胫前肌）肌力,单腿站立测试、Berg平衡量表、功能性步态测试、功能性伸展测试、计时起立-走测试评分,及其与步速的相关性。结果两组间体重、身高无显著性差异（P〉0.05）,可疑肌少症组年龄较大（P〈0.05）。双侧下肢肌群肌力两组间无显著性差异（P〉0.05）;髂腰肌、股四头肌、腘绳肌肌力与步速呈弱相关（r=0.121~0.227,P〈0.05）,胫前肌肌力与步速无显著相关性（P〉0.05）。步速与单腿站立试验呈弱相关（r=0.121~0.236,P〈0.05）,与Berg平衡量表、功能性步态测试、功能性伸展试验评分呈中度相关（r=0.479~0.584,P〈0.001）,与计时起立-走测试评分呈中度负相关（r=-0.502,P〈0.001）;除功能性伸展测试（P=0.28）外,其他测试两组间均有非常高度显著性差异（P〈0.001）。结论诊断肌少症不能仅依靠肌力,还应结合功能性活动。

偏瘫患者膝伸肌群等速离心收缩训练的效果

目的 :探讨等速离心收缩训练对偏瘫患者膝伸肌群力量及步速的改善情况 ,了解其是否加重偏瘫膝伸肌群痉挛程度并产生肌肉损害。方法 :应用Kin Com等速装置对 16例伴有膝伸肌群痉挛的偏瘫患者进行 3次 /周共 4周的等速离心收缩训练 ,训练前、后分别用等速被动测试方法以 30°/s、6 0°/s、12 0°/s角速度测定被动阻力力矩 (痉挛量化指标 ) ,以及受累侧膝伸不同角速度时的向心收缩、离心收缩力矩 ;同时用表面电极EMG记录股四头肌、绳肌的肌电信号 ;测定训练前及训练停止 3周后的自我习惯步态的 10m步速。训练停止 3周后 ,再次测定受累侧膝伸向心收缩力矩、离心收缩力矩。训练前和第 1次训练后 72h测定血中C反应蛋白和血肌酸激酶水平。结果 :训练后 ,受累侧膝伸向心收缩、离心收缩力矩显著增加 (P <0 0 5 ) ;痉挛程度保持稳定 (P <0 0 5 ) ;原动肌 (股四头肌 )平均EMG活动显著增加 (P <0 0 5 ) ,拮抗肌 (绳肌 )抑制活动变化较小 (P <0 0 5 ) ;步速增加 (P <0 0 5 )。停止训练后 3周时 ,受累侧膝伸肌力改善的百分比有所降低 ,但步速的改善基本保持 (P >0 0 5 )。第 1次训练后 72h血C反应蛋白和血肌酸激酶均未高于正常值。结论 :短期的等速离心收缩训练可显著地改善偏瘫患者肌力与步速 ,且不增加痉?

老年少肌性肥胖的患病率及其肌力和肌功能的调查

目的调查上海地区老年人少肌性肥胖患病率及其肌力、肌功能。方法复旦大学附属华东医院体检中心和周边社区786例年龄≥60岁老年人,平均年龄(72.1±8.0)岁,其中男性337例,女性449例。分为3个年龄段,60~69岁组,70~79岁组,80岁及以上组。入选受试者均完成身高、体重、握力、4 m步速测量,采用Inbody720人体成分分析仪检测全身骨骼肌肌量(SMM)、获得四肢骨骼肌肌量(ASM)、体脂肪百分比,并计算四肢骨骼肌指数(SMI,ASM/height2)。研究采用标准:肌量低下:SMI,男性<7.0 kg/m2,女性<5.7 kg/m2;肥胖:体脂百分比男性≥25%、女性≥30%;两者合并为少肌性肥胖;肌力低下:握力男性<27 kg,女性<16 kg;肌功能低下:4 m步速≤0.8m/s。结果1.不同性别老年人BMI差异无统计学意义(P>0.05);体重、身高、SMM、ASM、SMI、握力男性高于女性(P<0.05),体脂百分比、4 m步速女性高于男性,差异有统计学意义(P<0.05)。2.老年人群少肌性肥胖患病率男性23.1%,女性18.3%。并随年龄增加而增加,尤其是女性,差异有统计学意义(P<0.05)。3.少肌性肥胖人群的握力和4 m步速低于其他人群。结论少肌性肥胖随年龄增加患病率增加,女性尤为明显。少肌性肥胖人群肌力和肌功能低于其他人群。