中国临床医学2025，Vol.32Issue(3)：479-485,7.DOI:10.12025/j.issn.1008-6358.2025.20241482
基于老年综合评估的高龄肌少-骨质疏松症危险因素筛查与综合干预研究:一项≥80岁患者的应用分析
Comprehensive geriatric assessment-based screening and integrated intervention for osteosarcopenia risk factors in older adults:an application analysis in patients aged≥80 years
摘要
Abstract
Objective To explore the utility of comprehensive geriatric assessment(CGA)in screening risk factors for osteosarcopenia(OS)among older adults(≥80 years old)and to evaluate the therapeutic efficacy of CGA-guided integrated interventions for OS.Methods A total of 420 patients aged≥80 years,recruited from the Department of Geriatrics,General Practice of The Affiliated Jiangyin Hospital of Nantong University,and community health centers from January 2022 to October 2024,were enrolled.Participants were classified into OS(n=139)and non-OS(n=281)groups based on diagnostic criteria.CGA was utilized to compare differences in general characteristics,laboratory indicators,comorbidities between groups.Binary logistic regression analysis identified independent risk and protective factors.Subsequently,40 OS patients were randomly assigned to an intervention group(n=20)receiving integrated interventions including nutritional support,exercise training,and psychological management or a control group(n=20,receiving routine care).Appendicular skeletal muscle mass index(ASMI),grip strength,gait speed,and bone mineral density(BMD)T-score were compared between groups after 3 months.Results The prevalence of OS in this cohort was 33.1%.Compared to the non-OS group,the OS group exhibited significant differences in age,body mass index(BMI),smoking history,comorbidity index,concomitant medication,cognitive impairment,visual and hearing impairment,sleep disorders,depression,marital status,social participation,activities of daily living,nutritional risk,total cholesterol,uric acid,and constipation(P＜0.05).Logistic regression analysis identified age and comorbidity index as significant risk factors for OS,while BMI,married status,total cholesterol,and activities of daily living(assisted and independent)served as protective factors.The intervention group demonstrated significant improvements in grip strength,gait speed,BMD T-score,and male ASMI compared to controls(P＜0.05).Conclusions CGA demonstrates clinical utility in systematically identifying risk factors for OS in the old population.Multimodal interventions guided by CGA effectively improve musculoskeletal function in elderly OS patients.关键词
老年综合评估/肌少症/骨质疏松/高龄患者Key words
comprehensive geriatric assessment/sarcopenia/osteoporosis/elderly patient分类
医药卫生引用本文复制引用
张恬,沙江明,江黎明,殷泉忠,顾一航..基于老年综合评估的高龄肌少-骨质疏松症危险因素筛查与综合干预研究:一项≥80岁患者的应用分析[J].中国临床医学,2025,32(3):479-485,7.基金项目
江苏省卫生健康委员会临床适宜技术推广应用项目(LSD2022007),江苏省卫生健康委员会临床技术应用研究项目(LD2022005),江阴市卫生健康委指导性科研项目(G202101),江阴市科技创新专项资金(JY0603A021014210015PB).Supported by Clinical Appropriate Technologies Promotion and Application Project of Jiangsu Provincial Health Commission(LSD2022007),Clinical Technology Application Research Project of Jiangsu Commission of Health(LD2022005),Guided Scientific Research Project of Jiangyin Municipal Health Commission(G202101),and Science and Technology Innovation Special Fund of Jiangyin(JY0603A021014210015PB). （LSD2022007）
