OBJECTIVES:Sarcopenia is associated with functional disability in older adults. However, no consistent conclusions have been reached considering the differences in the measurement and criteria of sarcopenia. We aimed to examine the association between sarcopenia status and functional disability based on China Health and Retirement Longitudinal Study (CHARLS). DESIGN:A nationally representative longitudinal study. SETTING AND PARTICIPANTS:Participants aged at least 60 years old from the CHARLS 2015y were included. MEASUREMENTS:Sarcopenia was assessed according to the Asian Working Group for Sarcopenia 2019 algorithm. The outcomes of this study were basic activities of daily living (ADLs) and instrumental activities of daily living (IADLs). The logistic regression model was conducted to analyze the cross-sectional and longitudinal associations between sarcopenia status and ADLs and IADLs disability. RESULTS:In the cross-sectional study, 37.2% of the 6893 participants were defined as having sarcopenia. Any form of sarcopenia was associated with ADLs and IADLs disability. During three years of follow-up, 786 (16.5%) participants developed new-onset ADLs disability, and 980 (22.5%) participants developed new-onset IADLs disability. Compared with the no-sarcopenia, participants with possible sarcopenia (OR: 1.62, 95%CI: 1.34-1.95), sarcopenia (OR: 1.58, 95%CI: 1.18-2.11), or total sarcopenia (OR: 1.58, 95%CI: 1.34-1.88) had a higher risk of ADLs disability. While, the risk of IADLs disability for participants with possible sarcopenia (OR: 1.68, 95%CI: 1.41-2.00), sarcopenia (OR: 1.87, 95%CI: 1.40-2.51), or total sarcopenia (OR: 1.71, 95%CI: 1.45-2.00) was still significantly increased. With statistical interaction between sarcopenia status and residence or sex in ADLs and IADLs disability, older adults in urban, with ORs ranging from 2.14 to 2.44, were at a higher risk of functional disability than those in rural. Possible sarcopenia was associated with a much higher risk of ADLs disability (OR: 1.68, 95%CI: 1.26-2.25) in males and a higher risk of IADLs disability (OR: 1.98, 95%CI: 1.56-2.52) in females. CONCLUSIONS:Sarcopenia was associated with an increased risk of ADLs and IADLs disability among older Chinese adults. Even possible sarcopenia still significantly impacted ADLs and IADLs disability, and this association varied by sex and residence.

目的 观察特征性引导运动想象训练对脑卒中偏瘫患者焦虑、抑郁及残疾接受度的影响.方法 于2018年10月～2019年5月选取河北省保定市泰和康复医院住院的脑卒中偏瘫患者70例为研究对象,焦虑、抑郁评分≥8分.随机分为观察组和对照组.对照组给予神经外科常规康复治疗及护理,观察组在此基础上增加特征性引导运动想象训练.分别于干预前、干预4周后应用医院焦虑抑郁量表(H ADS)、残疾接受度量表(ADS-R)评测,比较疗效.结果 干预4周后,观察组焦虑得分为(9.66±1.589)分、抑郁得分为(10.06±1.626)分,总分为(19.71±2.191)分,均明显低于对照组,差异有统计学意义(P<0.05);ADS-R扩大维度得分为(23.60±1.499)分、从属维度得分为(12.91±1.095)分、转变维度得分为(22.11±1.451)分,总分为(81.11±3.437)分,均明显高于对照组,差异有统计学意义(P<0.05).结论 特征性引导运动想象训练可有效改善脑卒中偏瘫患者焦虑、抑郁及残疾接受度.

目的 观察社区高龄老年人的认知功能现状并分析其影响因素.方法 整群随机选取唐山市2所医院的10个社区卫生服务站的75岁以上老年人3448名,进行认知功能评估,进行加利福尼亚大学洛杉矶分校(UCLA)孤独量表、衰弱综合评估量表(CFAI)、日常生活能力(ADL)量表及其他相关因素的筛查.结果 社区老年人的认知功能障碍检出率为29.8％.多因素分析结果显示,孤独感程度中上及以下(均OR<1)、邻里来往很少及以上、轻度照护需求及以上是社区老年人认知功能的保护因素,读书看报和接受居委会服务偶尔及更多是影响认知功能的危险因素.结论 老年人照护需求和孤独感状况等因素对其认知功能产生了严重影响,为预防标准的指定提供了可借鉴经验.健康和生活,为降低认知功能障碍检出率,应重视对影响认知功能各因素的控制.

目的 分析老年膝关节骨关节炎(KOA)患者的体重指数(BMI)对关节症状的影响.方法 采用整群抽样的方法随机抽取唐山市两个社区的KOA患者,应用一般资料调查表、骨关节炎发病情况调查表、骨关节炎指数评估表(WOM-AC)对老年KOA患者的关节症状、BMI情况进行调查.结果 参与本次调查研究的老年KOA患者共196例,BMI均值为(23.14±3.41)kg/m2,正常组127例(64.8％),超重组41例(20.9％),肥胖组28例(14.3％).BMI越高者,WOMAC各维度及总分评分越高,差异具有统计学意义(P<0.05).与正常组比较,肥胖组表现为病程长、跌倒的发生率高、发病关节以双侧居多,差异具有统计学意义(P<0.05).结论 老年KOA患者BMI越高,关节炎症状越严重,发生跌倒的风险也增加.建议加强对KOA患者的早期干预,对老年KOA患者给予饮食、运动等多方面的指导,控制BMI,延缓关节炎症状的发展,提高患者生活质量.