台灣南部日間照顧機構老人樣本族群肌少症之盛行率與其相關因素之探討

Prevalence and correlates of sarcopenia among a sample of older adults attending daycare centers in southern Taiwan

"目標：瞭解日間照顧機構老人肌少症的盛行率與相關因素。 方法：採橫斷式與立意取樣設計，對台灣南部6家日間照顧機構65歲老人進行訪談。收集資料包括基本資料、身體質量指數、簡易心智狀態問卷調查表、巴氏量表，以及肌少症指標（肌肉質量、手握力與6公尺走路速度）。 結果：研究樣本共165位（男68位、女97位），平均年齡78.9±8.2歲；1/3個案（34.5%）最近一年內有跌倒情形；約1/4個案（23.6%）的BMI值小於21 kg/m2；超過6成（60.6%）個案有中重度認知缺損；一半以上（53.9%）個案屬於中重度依賴。以2019亞洲肌少症工作小組診斷切點計算，約5成（51.5%）個案有肌少症，男女比率相當。以多變量邏輯斯迴歸（Enter method）分析後，發現與肌少症相關的獨立危險因子有高齡、低身體質量指數、洗澡障礙與平地走動障礙四個變項，其OR值（95% Confidence interval）分別為1.06（1.00-1.12）、0.63（0.53-0.75）、3.76（1.01-13.99）、6.56（1.31-32.92）四個項目（p<0.05），其餘變項如上述兩項以外的巴氏量表中各變項、性別、教育程度、共病指標、一年內有跌倒史，以及認知狀態未達統計顯著。 結論：本研究日照機構樣本肌少症盛行率超過五成。對於日照老人合併有低身體質量指數、洗澡能力及平地走動能力障礙者，需特別留意肌少症發生的可能與風險，以便及早偵測並採取相關策略來延緩或降低肌少症導致的相關危害。（台灣衛誌2021；40(2)：213-222）"

Objectives: Examine the prevalence of sarcopenia and its correlates. Methods: In this cross-sectional study, 68 men and 97 women aged ≥ 65 years were recruited from 6 daycare centers in Southern Taiwan. In addition to recording participant demographic characteristics, the following were measured: body mass index, Short Portable Mental State Questionnaire, Barthel Index, handgrip strength, 6-m walking speed, and muscle mass index (through bioelectrical impedance analysis). The diagnosis of sarcopenia was made according to the 2019 criteria of the Asian Working Group for Sarcopenia (AWGS). Results: Among the 165 participants (mean age: 78.9 ± 8.2 years), 34.5% had fallen in the preceding year, and nearly one-fourth (24.2%) had a BMI value of <21 kg/m2; moreover, 60.6% of participants had moderate to severe cognitive impairment, and 53.9% were moderately to severely dependent in activities of daily living. The prevalence of sarcopenia was 51.5%, which is 6.0% higher than the prevalence obtained when using the criteria recommended by the European Working Group on Sarcopenia in Older People. Multivariate logistic regression revealed that sarcopenia was independently associated with (1) advanced age, (2) a low BMI, and inability to (3) bathe and (4) walk on a flat surface. The odds ratios (95% confidence interval) for these 4 independent variables were 1.06 (1.00-1.12), 0.63 (0.53-0.75), 3.76 (1.01-13.99), and 6.56 (1.31-32.92), respectively. Conclusions: Sarcopenia was highly prevalent in this study's sample. Instead of merely focusing on older adults with advanced age or a low BMI, health providers should focus more on older adults who are unable to bathe and walk on a flat surface; such people are at particular risk of suffering from sarcopenia, which further leads to serious health problems. Moreover, further intervention to prevent or delay the onset of sarcopenia may improve geriatric care in daycare centers. (Taiwan J Public Health. 2021; 40(2): 213-222)