老年肌少症之診斷與治療

Sarcopenia in the Elderly: Diagnosis and Treatment

台灣2012年65歲以上老年人口比率為11.15%，預計在2026年老年人口比率將達到20%，步入超高齡社會。近年來老人照護重要議題之一「肌少症」被逐漸加以重視。目前全世界老年肌少症之盛行率介於9.5%到50%，且隨著年齡越長其盛行率越高，預估40年之後將影響超過2億人。肌少症發生有多種成因包括老化過程、不適當的飲食、臥床或久坐的生活習慣、慢性疾病、賀爾蒙等。肌少症判讀之截切點（cut off point），為肌肉質量低於18-40歲的年輕族群2個標準差即判定為肌少症。測量部位以股四頭肌為最常被用來檢測部位，社區測量儀器則以生物阻抗分析儀（bioelectrical impedance analysis, BIA）較合適，因其具不昂貴、容易操作及攜帶。高齡者因肌肉量減少導致肌少症，將造成行動失調、跌倒、骨折、喪失獨立生活能力、衰弱和死亡風險增加。因此，積極發展高齡長者肌少症之周全性照護，包括提供抗阻力運動、充足蛋白質攝取及維生素D補充等，將是未來護理專業人員須要致力研究及發展的重要目標。

The proportion of the population aged 65 years and older in Taiwan was 11.15% in 2012. This is expected to rise to 20% in 2026, at which time, the country would become a super-aged society. Sarcopenia, with a worldwide prevalence among people 65 years of age and older between 9.5% and 50%, has gained increasing attention in recent years. It is estimated that two-hundred million people worldwide will suffer from sarcopenia within 40 years. The various causes of sarcopenia include aging, inappropriate diet, a bedridden or sedentary lifestyle, chronic diseases, and hormones. The definition and interpretation of sarcopenia uses a cutoff point of 2 standard deviations below the muscle mass in young adults between the ages of 18 and 40 years. The quadriceps muscles are most commonly used to assess sarcopenia. A bioimpedance analyzer is appropriate for community-based assessment work because this instrument is inexpensive, easily operated, and portable. Decreased muscle mass in the elderly causes sarcopenia, which leads to movement disorders, fall events, fractures, loss of the capacity to live independently, frailty, and increased mortality risk. Therefore, developing a comprehensive care program for sarcopenia, including resistance training and sufficient protein and vitamin D intake, should be a priority task and important research focus for nursing professionals.