老年人群预测活动受限的握力临界值确定

关键词：老年人  握力  临界值  活动受限

Keywords:elderly  grip strength  cutoff  mobility limitation

摘要：

      摘要 目的：确定预测老年人群活动受限的握力临界值，为预防老年人活动受限提供一定参考依据。 方法：选取天津市汉沽区60岁以上老年人1311例，其中男性591例，女性720例。对受试者进行问卷调查、体格检查和生化指标检测。采用受试者工作特征曲线（receiver operating characteristic， ROC）确定握力临界值，应用logistic回归分析握力临界值对于老年人群活动受限的预测价值。 结果：老年男性活动受限患病率为13.4%，女性活动受限患病率为18.8%。ROC结果显示，老年男性握力临界值为32.5kg，曲线下面积（area under the curve， AUC）为0.765（0.709，0.822），敏感度为69.70%，特异度为75.30%，女性握力临界值为18.2kg，AUC为0.704（0.655，0.752），敏感度为53.30%，特异度为78.1%。logistic回归分析显示，调整混杂因素后，与高于握力临界值者相比，低于握力临界值的男性和女性活动受限发生风险OR值分别是2.584（1.299， 5.180）和1.839（1.154， 2.932）。 结论：握力水平可以预测老年人活动受限的风险，预测老年人群活动受限的男女性握力临界值分别为32.5kg和18.2kg，对降低老年人活动受限风险提供一定参考价值。

Abstract:

      Abstract Objective： To explore the threshold value of grip strength in the elderly population to predict mobility limitation， and to provide objective basis for clinical prevention of mobility limitation in the elderly. Method： A total of 1311 elderly people over 60 years old were recruited in Hangu District， Tianjin， including 591 males and 720 females. Subjects underwent questionnaire survey， physical examination and biochemical index detection. Receiver operating characteristic(ROC) curve was used to determine the threshold value of grip strength， and Logistic regression was used to analyze the predictive value of grip strength threshold for activity limitation in elderly population. Result： In this study， 13.4% of the elderly males and 18.8% of the elderly females had mobility limitation. The ROC results showed that the critical value of grip strength was 32.5kg， the AUC was 0.765(0.709，0.822)， and the sensitivity and specificity were 69.70% and 75.30% for elderly men， and the critical value of grip strength was 18.2kg， the AUC was 0.704(0.655，0.752)， the sensitivity and specificity were 53.30% and 78.1% for elderly women. Logistic regression analysis showed that after adjusting for confounding factors， compared with those above the grip strength threshold， the OR values of men and women below the grip strength threshold were 2.584(1.299， 5.180) and 1.839(1.154， 2.932)， respectively. Conclusion： Grip strength is a very practical tool to predict the risk of mobility limitation in the elderly. The critical value of grip strength for predicting activity limitation in the elderly population was 32.5kg and 18.2kg，respectively，which could provide reference for reducing mobility limitation risk in the elderly population.