呼吸困难与虚弱和肌肉减少症具有共同的衰老机制。虚弱和肌肉减少症与呼吸困难本身相关吗？我们分析了一项基于人群的前瞻性队列研究的数据，该研究涉及 780 名社区老年人。呼吸困难的定义是使用改良的医学研究委员会呼吸困难量表（≥2分）和慢性阻塞性肺疾病评估测试（≥10分）。衰弱通过衰弱指数（FI）、衰弱表型和 FRAIL 问卷来定义。肌肉减少症由 2019 年亚洲肌肉减少症工作组定义。肌肉减少症表型评分量化了满足标准的数量。通过逻辑回归分析评估虚弱和肌肉减少症与呼吸困难的关联。计算调整优势比（aOR），考虑年龄、性别、慢性气道疾病、吸烟状况、体重指数、肺功能、社会经济状况（独居、收入、教育）、合并症（高血压、糖尿病、恶性肿瘤、心肌病）梗死、心力衰竭）和其他老年因素（认知功能障碍、抑郁、营养不良、多药治疗、过去一年跌倒史）。通过对数秩检验比较无住院生存率。与非呼吸困难组相比，呼吸困难组的虚弱患病率较高（FI 为 42.6% vs. 10.5%，虚弱表型为 26.1% vs. 8.9%，以及 23.0%）。 % vs. FRAIL 的 4.2%）和肌少症（38.3% vs. 26.9%），所有比较的 P < 0.01。多变量逻辑回归分析显示衰弱（FI [aOR：9.29]、FRAIL 问卷 [aOR：5.21] 和衰弱表型 [aOR：3.09]）和肌少症表型评分（评分 2 [aOR：2.00] 和评分 3 [aOR：2.00] : 2.04] 与分数 0 相比）与呼吸困难相关。呼吸困难组的无住院生存累积发生率高于对照组（P = 0.02）。研究结果表明，虚弱和肌肉减少症是社区老年人呼吸困难的重要原因。测量老年人的肌少症和虚弱可能为预防与年龄相关的呼吸困难提供机会。版权所有 © 2024。由 Elsevier Inc. 出版。

Breathlessness shares aging mechanisms of frailty and sarcopenia.Are frailty and sarcopenia associated with breathlessness itself?We analyzed data from a population-based, prospective cohort study of 780 community-dwelling older adults. Breathlessness was defined using the modified Medical Research Council Dyspnea Scale (≥2 points) and the Chronic Obstructive Pulmonary Disease Assessment Test (≥10 points). Frailty was defined by frailty index (FI), frailty phenotype, and FRAIL questionnaire. Sarcopenia was defined by the Asian Working Group for Sarcopenia 2019. Sarcopenia phenotype score quantifies the number of criteria met. The associations of frailty and sarcopenia with breathlessness was evaluated by logistic regression analyses. Adjusted odds ratio (aOR) were calculated, accounting for age, sex, chronic airway disease, smoking status, body mass index, lung functions, socioeconomic status (living alone, income, education), comorbid conditions (hypertension, diabetes, malignancy, myocardial infarction, heart failure), and other geriatric contributors (cognitive dysfunction, depression, malnutrition, polypharmacy, fall history in the past year). Institutionalization-free survival was compared by log-rank test.The prevalence of frailty is higher in the breathlessness group compared to non-breathlessness group (42.6% vs. 10.5% by FI, 26.1% vs. 8.9% by frailty phenotype, and 23.0% vs. 4.2% by FRAIL) and sarcopenia (38.3% vs. 26.9%), with P < 0.01 for all comparisons. The multivariable logistic regression analyses showed that frailty (FI [aOR: 9.29], FRAIL questionnaire [aOR: 5.21], and frailty phenotype [aOR: 3.09]) and sarcopenia phenotype score (score 2 [aOR: 2.00] and score 3 [aOR: 2.04] compared to score 0) were associated with breathlessness. The cumulative incidence of institutionalization-free survival was higher in the breathlessness group than counterparts (P = 0.02).The findings suggest that frailty and sarcopenia strongly contribute to breathlessness in community-dwelling older adults. Measuring sarcopenia and frailty in older adults may offer opportunities to prevent age-related breathlessness.Copyright © 2024. Published by Elsevier Inc.