マレーシアでの握力測定と入院期間

マレーシアでの握力測定と入院期間の関連をみた論文を紹介します。

Keevil V, Mazzuin Razali R, Chin AV, Jameson K, Aihie Sayer A, Roberts H. Grip strength in a cohort of older medical inpatients in Malaysia: A pilot study to describe the range, determinants and association with length of hospital stay. Arch Gerontol Geriatr. 2012 Oct 29. pii: S0167-4943(12)00209-9. doi: 10.1016/j.archger.2012.10.005. [Epub ahead of print]

入院高齢患者における握力測定に関する研究は、アジアではあまり行われていません。そこで老年病棟の入院患者を対象に、握力測定の実現可能性と入院期間との関連を調査しました。

結果ですが、153人中80人が対象となりました。このうち76人で握力測定が可能でしたが、コーカシアンより握力は低かったです。抄録しか読めていないため、どのくらい低いかはわかりません。性別、年齢、身長で調整しても、握力は入院期間と有意な関連を認めました（握力が高いと入院期間が短い）。

握力はサルコペニアの診断に使用されるだけでなく、栄養指標としても見直されています。握力を用いた観察研究が日本でももっと増えてよいのではと感じています。実現可能性が高いですし。

Abstract

Grip strength is a marker of sarcopenia, the age-related decline in muscle mass and function, and has been little researched in Asian populations. We aimed to describe the feasibility and acceptability of measuring grip strength in hospitalized, older people in Malaysia and to explore its range, determinants and association with length of stay. Patients admitted acutely to the geriatrics ward of a teaching hospital were consecutively recruited. Inability to consent or use the dynamometer led to exclusion. Maximum grip strength, anthropometric data, length of hospital stay, discharge destination, 3-point Barthel score, mini-mental state examination, falls history and number of co-morbidities and medications on admission were recorded. 80/153 (52%) eligible patients were recruited (52 women; age range 64-100 years). 9/153 (6%) refused to participate and 64/153 (42%) were excluded (34 too unwell, 24 unable to consent, 4 unable to use the dynamometer, 2 other reasons). 76/80 patients (95%) reported that they would undergo grip strength measurement again. Determinants were similar to those of Caucasian populations but grip strength values were lower. After adjustment for sex, age and height, stronger grip strength was associated with shorter length of stay [hazard ratio 1.05 (95% CI 1.00, 1.09; P=0.03)]. This is the first report of grip strength measurement in hospitalized older people in Malaysia. It was feasible, acceptable to participants and associated with length of stay. Further research is warranted to elucidate the normative range in different ethnic groups and explore its potential use in clinical practice in Malaysia.