背景:本研究旨在评估年龄最大的老年人呼吸肌力量与肌肉减少症及其指标的关联。
方法:最大吸气压力(MIP),最大呼气压(MEP)和肌肉减少症相关因素(手握力和阑尾瘦体重)在一组n=286(女性45.5%)非体弱者中进行了评估,83.6±3.0岁的社区居民(年龄范围80-97岁)。
结果:样本显示肌肉减少症患病率为32.2%。肌少症患者的MIP和MEP与非肌少症患者相当(女性:MIP43.9±18.9对50.3±19.5,p=0.053;MEP63.0±23.0对69.2±19.1,p=0.067;男性:MIP,65.1±24.4对64.4±23.9,p=0.433;MEP87.7±33.3对93.8±30.9,p=0.124)。在握力和MIP之间发现了统计学上的显着但非常低的关联(男性的r=0.193,女性参与者p<0.05,r=0.257,p<0.01)和MEP(男性r=0.200,女性参与者p<0.01,r=0.191,p<0.05)。女性瘦体重与MIP和MEP显著相关(r=0.253,p<0.01,r=0.343,p<0.01),而在男性参与者中没有发现这种关联.握力是MEP的唯一有统计学意义的预测因子(r平方=0.212,p<0.001),虽然MIP是按年龄独立预测的,男性性别和握力(r平方=0.177,p<0.001)。
结论:外周肌力具有统计学意义,尽管在功能良好的情况下呼吸肌力量的预测指标较弱,80岁以上的社区居民。当面对低握力时,应该意识到伴随的呼吸肌无力,因为这是肺不张和肺炎的已知危险因素。鉴于与手握强度的关联相对较低,可能需要进行呼吸肌力量测试。
This study aimed to evaluate the association of respiratory muscle strength with sarcopenia and its indicators in the oldest old.
Maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), and sarcopenia-related factors (handgrip strength and appendicular lean mass) were evaluated in a cohort of n = 286 (45.5% female) non-frail, community-dwelling persons aged 83.6 ± 3.0 years (age range 80-97 years).
The sample presented a sarcopenia prevalence of 32.2%. Sarcopenic subjects showed comparable MIP and MEP as non-sarcopenic ones (female: MIP 43.9 ± 18.9 vs. 50.3 ± 19.5, p = 0.053; MEP 63.0 ± 23.0 vs. 69.2 ± 19.1, p = 0.067; male: MIP, 65.1 ± 24.4 vs. 64.4 ± 23.9, p = 0.433; MEP 87.7 ± 33.3 vs. 93.8 ± 30.9, p = 0.124). Statistically significant but very low associations were found between grip strength and MIP (r = 0.193 for male, p < 0.05 and r = 0.257 for female participants, p < 0.01) and MEP (r = 0.200 for male, p < 0.01 and r = 0.191 for female participants, p < 0.05). Lean mass was significantly correlated to MIP and MEP in female (r = 0.253, p < 0.01 and r = 0.343, p < 0.01, respectively), whereas this association was not found in male participants. Grip strength was the only statistically significant predictor of MEP (r2 = 0.212, p < 0.001), while MIP was independently predicted by age, male sex, and grip strength (r2 = 0.177, p < 0.001).
Peripheral muscle strength is a statistically significant, albeit weak predictor for respiratory muscle strength in well-functioning, community-dwelling persons aged 80+. When confronted to a low grip strength, one should be aware of concomitant respiratory muscle weakness, as this is a known risk factor for atelectasis and pneumonia. Given the relatively low association with handgrip strength, respiratory muscle strength testing might be indicated.