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握力对老年住院患者内在能力的影响

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目的 探讨握力对老年人内在能力的影响,以及不同性别老年患者握力与内在能力子域的关系.方法 横断面研究,纳入2020年5月至2021年11月浙江医院老年病科住院患者201例,收集患者一般情况及内在能力评估资料(包括躯体功能、营养状况、视力及听力情况、认知功能和抑郁情绪),根据内在能力受损子域数量分组,采用多元有序Logistic回归分析老年人内在能力子域受损的影响因素;并根据男性握力小于26 kg、女性握力小于18 kg将患者分为握力正常和握力下降组,使用二分类Logistic回归分析不同性别的老年患者握力与内在能力子域的关系.结果 201例患者内在能力子域受损0~1个者68例(33.8%)、2~3个者103例(51.2%)、>3个者30例(14.9%).多元有序Logistic回归分析调整混杂因素后,握力越大(OR=0.957,95%CI:0.924~0.993,P=0.019)的老年患者内在能力受损子域越少.201例患者中握力正常117例(58.2%)、握力下降84例(41.8%),不同性别老年人的二分类Logistic回归分析调整混杂因素后结果显示,握力下降的老年男性内在能力认知领域(OR=3.919,95%CI:1.301~11.804,P=0.015)易受损,握力下降的老年女性内在能力运动(OR=10.623,95%CI:2.374~47.536,P=0.002)、活力(OR=7.386,95%CI:1.875~29.095,P=0.004)和认知(OR=4.835,95%CI:1.218~19.196,P=0.025)子域均易受损.结论 握力下降的老年患者应是内在能力筛查的重点人群,不同性别握力下降的老年患者其内在能力受损子域存在差异,在制定改善内在能力的干预方案时应有不同侧重.
The effect of handgrip strength on intrinsic capacity in elderly inpatients
Objective To examine the influence of handgrip strength(HGS)on the intrinsic capacity(IC)and explore the correlation between HGS and intrinsic capacity subdomains in elderly patients of varying genders.Methods A cross-sectional study was conducted on 201 inpatients admitted to the Geriatric Department of Zhejiang Hospital from May 2020 to November 2021.The study collected data on the patients'general situation and intrinsic capacity assessment,which included physical function,nutritional status,visual and hearing status,cognitive function,and depressive mood.The patients were grouped based on the number of impaired subdomains of intrinsic capacity.Multivariate ordered Logistic regression analysis was performed to identify the factors influencing the impaired subdomains of intrinsic capacity.The patients were further divided into normal and decreased grip strength groups based on HGS thresholds of less than 26 kg for males and less than 18 kg for females.Binary Logistic regression analysis was then used to investigate the relationship between HGS and the different subdomains of intrinsic capacity among males and females.Results Among the 201 inpatients,68 were impaired in 0 to 1 subdomain(33.8%),103 in 2 to 3 subdomains(51.2%),and 30 in more than 3 subdomains(14.9%).After adjusting for confounding factors using multivariate ordered Logistic regression analysis,the HGS of the 2 to 3 and more than 3 subdomain groups were found to be lower than the 0 to 1 subdomain group(OR=0.957,95%CI:0.924-0.993,P=0.019).Among the patients,117(58.2%)had normal HGS,while 84(41.8%)had decreased HGS.In the binary Logistic regression analysis of older adults,adjusted for confounders,the results indicated that older men with decreased HGS had higher odds of experiencing cognition problems(OR=3.919,95%CI:1.301-11.804,P=0.015).Similarly,older women with decreased HGS had higher odds of having locomotion(OR=10.623,95%CI:2.374-47.536,P=0.002),vitality(OR=7.386,95%CI:1.875-29.095,P=0.004),and cognition(OR=4.835,95%CI:1.218-19.196,P=0.025)problems.Conclusions The key population for intrinsic capacity screening should be elderly patients with decreased HGS.It is important to note that there are differences in the subdomains of impaired intrinsic capacity among elderly individuals with decreased HGS of different genders.As a result,it is crucial to prioritize the development of intervention programs to improve intrinsic capacity based on the specific needs of elderly individuals of different genders.

Hand strengthInpatientsIntrinsic capacity

王菁、陈旭娇

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浙江中医药大学第二临床医学院,杭州 310053

浙江中医药大学临床医学院,杭州 310000

握力 住院患者 内在能力

国家重点研发计划浙江省科技厅重大社会公益计划浙江省卫生高层次创新人才项目(2022)国家重点研发计划

2020YFC20090012023C031622022-12020YFC2008606

2024

中华老年医学杂志
中华医学会

中华老年医学杂志

CSTPCD北大核心
影响因子:1.606
ISSN:0254-9026
年,卷(期):2024.43(3)
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