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Objective:To explore the effects of frailty syndrome on activities of daily living and its associated risk for adverse outcomes among elderly residents in China.Methods:Using open data from "China Health and Retirement Longitudinal Survey", the 2011 baseline survey was conducted on general information, health risk factors, chronic disease, data obtained from various ability assessments and Fried frailty criteria assessments for community elderly aged 60 years and over.The follow-up data were used to analyze the adverse outcomes of frailty syndrome using a covariation-adjusted Logistic regression model.Results:Among the 5 630 people in the baseline population, 34.9%(1 963/5 630 cases)were non-frailty, 57.4%(3 236 cases)were pre-frailty, and 7.7%(431 cases)were frailty.The frailty group had higher rates of falls, hip fractures, hospitalizations, and death than the pre-frail and non-frail groups at the 3rd, 5th, and 8th years of follow-up.At follow up to 2015, the covariate-adjusted analysis of the study population showed that as compared with the non-frail group, the frail group had increased risks of falling( OR=1.738, 95% CI: 1.292-2.338, P<0.001), increased risks of hip fracture( OR=2.672, 95% CI: 1.365-5.233, P=0.004), increased risks of hospitalization( OR=1.670, 95% CI: 1.224-2.277, P=0.001), increased risk of death( OR=1.599, 95% CI: 1.256-2.035, P<0.001), increased risks of declined upper limb activity( OR=2.769, 95% CI: 2.101-3.650, P<0.001), of declined instrumental activity of daily living( OR=2.567, 95% CI: 1.941-3.395, P<0.001), and of declined basic activities of daily living( OR=2.790, 95% CI: 2.110-3.689, P<0.001). Conclusions:Frailty syndrome increases the risk of decreased ability to live, falls, hip fractures, hospitalization and death in older adults.Frailty screening is an effective tool for predicting the risk of adverse outcomes in elderly community populations.
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Sarcopenia is a geriatric syndrome characterized by loss of skeletal muscle mass and strength and functional decline due to aging.In recent years, with the increase of the aging population, the incidence of the disease continues to rise.It is associated with a variety of adverse events such as falls, frailty, increased mortality, and other adverse events.Therefore, as research continues to lead to improved understanding on risk factors, pathophysiological mechanisms and intervention of sarcopenia, rehabilitation has become an important means in clinical treatment.This paper systematically reviews the progress in rehabilitation therapy for patients with sarcopenia, in order to summarize evidence for clinical intervention of sarcopenia.
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Objective:To investigate the prevalence of sarcopenia among community-dwelling Chinese elderly and to explore the related factors.Methods:Data were obtained from the China Health and Retirement Longitudinal Survey(CHARLS)in 2015, an open national database.According to the criteria of the Asian Working Group(AWGS)on Sarcopenia in 2014, a cross-sectional survey was conducted on 7 584 Chinese residents aged 60 years and over who had undergone the standard sarcopenia test.General socio-demographic characteristics and living habits were compared between different gender groups.The prevalence of sarcopenia was analyzed with stratification.Multivariate Logistic regression analysis was used to analyze risk factors for sarcopenia.Results:The overall prevalence of sarcopenia was 6.4%(95% CI: 5.9-7.0)among the Chinese population aged 60 years or older.In the stratified analysis, the prevalence of sarcopenia was higher in males(9.9%, 95% CI: 9.0-10.9)than in females(3.0%, 95% CI: 2.4-3.5), in rural areas(7.2%, 95% CI: 6.5-7.9)than in urban areas(4.3%, 95% CI: 3.4-5.2), and in smokers(8.8%, 95% CI: 7.6-10.0)than in non-smokers(4.2%, 95% CI: 3.6-4.8). Multivariate Logistic regression showed that male gender( OR=5.368, 95% CI: 4.126-6.985)and old age( OR=1.191, 95% CI: 1.172-1.210)were risk factors for sarcopenia.In addition, the occurrence of sarcopenia was significantly associated with physical pain( OR=2.181, 95% CI: 1.695-2.673), alcohol consumption( OR=1.426, 95% CI: 1.057-1.923), low education level( OR=2.875, 95% CI: 1.577-5.241), increased waist circumference( OR=0.982, 95% CI: 0.973-0.990), decreased peak expiratory flow( OR=0.995, 95% CI: 0.994-0.997)and increased cystatin C levels( OR=2.088, 95% CI: 1.247-3.495)( P<0.05). Conclusions:The prevalence of sarcopenia is high among community-dwelling elderly in China, and the occurrence of sarcopenia is closely related to age, gender, education level, Waist circumference and alcohol consumption.
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Objective:To analyze the mean levels of skeletal muscle mass and strength in elderly patients with type 2 diabetes mellitus(T2DM), and to investigate the effects of chronic inflammatory factors and oxidative stress on them.Methods:A cross-sectional study was conducted on 120 patients with T2DM aged over 60 years and 126 elderly patients without diabetes(the control group). Skeletal muscle mass, strength and serum levels of chronic inflammatory factors interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)and 8-hydroxy-2′-deoxyguanosine(8-OHdG)were determined, and their effects on skeletal muscle mass and strength in elderly patients with T2DM were analyzed.Results:Compared with the control group, grip strength decreased in elderly patients with T2DM(25.03±7.85)kg vs.(29.52±7.73)kg( P<0.01), and skeletal muscle mass decreased(21.36±5.46)kg vs.(22.01±5.22)kg with no significant difference( P>0.05). Serum levels of 8-OHdG were higher in elderly patients with T2DM than in the control group(3.08±0.26)ng/L vs.(2.59±0.16)ng/L( P<0.01). Correlation and regression analysis results showed that 8-OHdG was an influencing factor for muscle strength in elderly patients with T2DM( R2=0.457)and that height and weight could be influencing factors for skeletal muscle mass in elderly patients with T2DM( R2=0.822). Conclusions:Skeletal muscle mass and strength decline in elderly T2DM patients, probably as a result of increased levels of oxidative stress.These findings may serve as evidence for sarcopenia intervention in elderly T2DM patients.
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Skeletal muscle is an important motor organ and also the largest endocrine target organ of the human body.Pathological changes of skeletal muscle have significant effects on physical mobility and functions of other organs.Sarcopenia, an age-related syndrome of skeletal muscle mass, strength and function decline, is a complex disease and its occurrence and progression are related to many systems and diseases.Sarcopenia significantly increases the rates of disability and mortality of the elderly and seriously threatens people's health.This article reviews the association of sarcopenia with common diseases of the respiratory, circulatory, digestive, skeletal and other systems, in order to gather evidence for consideration in clinical diagnosis and treatment.
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Objective To investigate the expression of anti mullerian hormone(AMH)in the serum of patients with ovarian endometriosis cyst and its clinical significance.Methods Fifty-one cases of ovarian endometriosis cyst from March 2014 to June 2016 in Maternal and Child Health Hospital Affiliated to Southern Medical University(observation group)and thirty-five cases of normal women who were diagnosed through physical examination(control group)were selected as the research objects.The observation group patients received laparoscopic ovarian endometriosis cystectomy treatment,enzyme-linked immunosorbent assay(ELISA) was applied to detect and analyze serum AMH in the control group at physical examination and in the observation group before surgery and at 1 month,3 months after surgery.Results (1)The preoperative serum AMH level of the observation group was significantly lower than that of the control group,the difference was statistically significant((2.45±0.68)μg/L vs.(3.75±0.80)μg/L,t=7.8604,P=0.0000).(2)Serum AMH level in the groups where the ages were above 35years was significantly lower than that of the age less than 35 group( (1.76±0.57)μg/L vs.(3.61±0.88)μg/L,t=9.1249,P=0.0000); the preoperative serum AMH level in the group where disease course was more than 12 months was significantly lower than that of the disease course less than 12 months group((2.03 ± 0.64)μg/L vs.(3.98 ± 0.91)μg/L,t=8.1408,P=0.0000); the preoperative serum AMH level in patients with dysmenorrhea was significantly lower than that of patients without dysmenorrhea((1.65±0.53)μg/L vs.(3.91±0.84)μg/L,t=11.7861,P=0.0000),the preoperative serum AMH level in the bilateral lesion group was significantly lower than that of the unilateral lesion((2.01±0.68) μg/L vs.(2.84±0.72)μg/L,t=4.2174,P=0.0001); there was no significant difference in the preoperative serum AMH level between patients with<5.0 cm diameter cyst and patients with smaller cyst((2.52 + 0.81)μg/L vs.(2.39 + 0.50)μg/L,t=0.8411,P=0.4029).The serum AMH level in the observation group at 3 months after surgery was significantly lower than that before surgery((2.45±0.68)μg/L vs.(1.81± 0.55) μg/L,t=24.3657,P=0.0000).Conclusion The expression of serum AMH level in patients with ovarian endometriosis is low,and it is closely related to the age,course of disease,history of dysmenorrhea and the location of the lesion.Laparoscopic ovarian cystectomy may reduce ovarian reserve capacity in patients with ovarian endometriosis.