高齡者低握力評估的切點分析：台灣南部複合式健檢的實證分析

Comparisons of cutoff points of poor grip strength for elderly people in southern Taiwan

目標：本研究以台灣南部某農業縣2017年複合式健檢高齡民眾的握力檢測資料進行分析，透過低握力評估切點分析，了解受試者虛弱的情形。方法：受試者為男性999人（73.69±6.39歲）、女性1,212人（72.76±6.04歲）。以電子握力測試儀進行施測；以SPSS 20.0統計軟體進行分析。結果：男女受試者百分位數20的握力值與AWGS的評估切點相近；以受試者性別和BMI進行調整的分析，男性低握力比例為5.79％－71.43％，女性為9.55％－63.64％。FNIHSP評估切點的分析，男性低握力比例為10.88％－47.７6％，女性為4.69％－31.37％。AWGS評估切點的分析則顯示男性低握力比例為10.88％－47.76％，女性為12.24％－45.10％。結論：三種切點的低握力評估結果，男女的低握力比普遍隨著年齡增加而遞增。其中，FNIHSP評估切點的分析，三個年齡層男性低握力比例大約都是女性的1.5倍，可見FNIHSP的評估切點並不適用於國內高齡者。以男女BMI調整的評估切點分析，不僅低握力比與國內男女高齡者的衰弱盛行率研究相近，也反映不同身體質量對個體衰弱的影響。至於AWGS所設定的女性評估切點對我國女性高齡而言，相對較高，建議進一步依年齡進行調整。此外，本次男性參與者握力相對較低，受試者間差異較大；因此，呼籲男性高齡者的衰弱情形需要更多的關注。 Objectives: The objectives of this study were to compare the cutoff points of poor grip strength defined by Fried, EWGSOP, FNIHSP, and IWGS by subjecting community-dwelling elderly people in Southern Taiwan to a comprehensive physical examination. Methods: Participants comprised 999 men (age: 73.69±6.39 years) and 1,212 women (age: 72.76±6.04 years). Handgrip strength was measured using digital dynamometers (TKK 5101). Results: The 20th percentile of both men and women concurred with AWGS criteria. According to the Fried frailty criteria by adjustment for BMI, the prevalence of poor grip strength ranged from 5.79% to 71.43% among men and from 9.55% to 63.64% among women. According to FNIHSP criteria, the prevalence of poor grip strength ranged from 10.88% to 47.76% among men and from 4.69% to 31.37% among women. According to IWGS criteria, the prevalence of poor grip strength ranged from 10.88% to 47.76% among men and from 12.24% to 45.10% among women. Conclusions: The prevalence of poor grip strength increased with age in both sexes. According to the FNIHSP criteria, the prevalence of poor grip strength of older men was almost 1.5 times that of women, indicating the unsuitability of the cutoff points for Asians older than 65 years. The prevalence of poor grip strength based on Fried frailty criteria by adjustment for BMI not only corresponded with that from previous research on frailty in Taiwan but also revealed the effect of BMI on aging. Based on the AWGS criteria, the cutoff point of poor grip strength for older women was higher than those in other local studies in Taiwan. Therefore, this study suggests that the age factor be considered in the cutoff point of the AWGS. Moreover, attention should be paid to the weaker performance and greater individual differences in grip strength among the male participants.