日本の地域在住高齢者のサルコペニア

日本の地域在住高齢者のサルコペニアの有病割合を調査した論文を紹介します。京都大学の山田実先生らの研究です。

Minoru Yamada, et al. Prevalence of Sarcopenia in Community-Dwelling Japanese Older Adults. Journal of the American Medical Directors Association, Available online 3 October 2013.
http://www.sciencedirect.com/science/article/pii/S1525861013005045

対象は65-89歳の健康な地域在住高齢者で男性568人、女性1314人です。サルコペニアの有無はEWGSOPの診断基準をベースにした判定基準で、筋肉量（BIA）、筋力（握力）、身体機能（10mの通常歩行速度）のうち、筋肉量減少＋（筋力低下もしくは身体機能低下）としています。

結果ですが、サルコペニアと判定されたのは男性21.8％、女性22.1％でした。サルコペニアの有病割合は年齢とともに増加し、特に75歳以上の男性、女性で顕著でした。サルコペニアは、young oldでは女性が多く、85歳以上では男性が多い結果でした。

さらに転倒および転倒恐怖は、サルコペニアを有する高齢者のほうが、サルコペニアでない高齢者と比較して、有意に多かったです。以上より、日本の健康な地域在住高齢者ではサルコペニアの有病割合が高く、サルコペニアは転倒および転倒恐怖と関連するという結論です。

日本の健康な地域在住高齢者の4-5人に1人がサルコペニアであり、転倒と転倒恐怖のリスクであるというのは、インパクトがあると考えます。図を見ると80歳以上で約4割、85歳以上で5割以上です。大腿骨近位部骨折になる前に何らかの早期発見、予防介入ができるといいですね。

Abstract

Background

Sarcopenia, the age-dependent loss of skeletal muscle mass, is highly prevalent among older adults in many countries; however, the prevalence of sarcopenia in healthy Japanese community-dwelling older adults is not well characterized.

Objective

The aim of this study was to evaluate the prevalence of sarcopenia and to examine the association of sarcopenia with falls and fear of falling in community-dwelling Japanese older adults.

Design

This is a cross-sectional study.

Setting and Subjects

Healthy men (568) and women (1314) aged 65 to 89 years participated in this research.

Measurements

For all participants, 3 measurements were taken: skeletal muscle mass measurement using bioelectrical impedance, 10 m at a usual walking speed, and handgrip strength. Sarcopenia was defined as the presence of both poor muscle function (low physical performance or low muscle strength) and low muscle mass.

Results

The prevalence of sarcopenia, determined using the European Working Group on Sarcopenia in Older People–suggested algorithm, in men and women aged 65 to 89 years was 21.8% and 22.1%, respectively. The prevalence of sarcopenia increased age-dependently, especially in those older than 75 years in both genders. In the young old, the prevalence of sarcopenia was higher in women than in men; however, in those older than 85 years, the prevalence of sarcopenia was lower in women than in men (P < .05). In addition, fall incidents and fear of falling were more prevalent in sarcopenic older adults than in nonsarcopenic older adults (P < .05).

Conclusions

These results suggest that sarcopenia is highly prevalent in community-dwelling Japanese older adults and is related to falls and fear of falling.