Background Half of all physical disability, including activity of daily living (ADL) disability, among older adults occurs in the setting of hospitalization. This study examines whether appendicular lean mass (ALM) and grip strength, which are commonly included in various definitions of sarcopenia, are associated with the development of hospital-associated ADL disability in older adults in the Health ABC Study. Methods Individuals hospitalized during the first 5 years of follow-up (n = 1 724) were analyzed. ALM to body mass index (BMI) ratio (ALMBMI), by dual-energy x-ray absorptiometry (DXA), and grip strength, by hand-held dynamometery, were assessed annually. Development of new ADL disability was assessed at the time of the next annual assessment after hospitalization. Separate regression analyses modeled the association of prehospitalization ALMBMI or grip strength with death before the next scheduled annual assessment. Next, among those who survived to the next annual assessment, separate regression analyses modeled the association of ALMBMI or grip strength with development of ADL disability. Results Each standard deviation decrement in prehospitalization grip strength was associated with an adjusted 1.80 odds of new ADL disability at follow-up (95% CI: 1.18, 2.74). Low, compared with not low, grip strength (per FNIH definition) was associated with an adjusted 2.36 odds of ADL disability at follow-up (95% CI: 1.12, 4.97). ALM measures were not associated with the development of hospital-associated ADL disability. ALM and grip strength measures were not associated with death. Conclusions Prehospitalization lower grip strength may be an important risk factor for ADL disability among older adult survivors of hospitalization.

中文翻译：

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Health ABC 研究中老年人的四肢瘦肉块、握力以及日常生活障碍医院相关活动的发展

背景 老年人中一半的身体残疾，包括日常生活活动 (ADL) 残疾，发生在住院期间。这项研究探讨了 Health ABC 研究中老年人的医院相关 ADL 障碍的发展是否与肌少症的各种定义中常见的阑尾瘦肉块 (ALM) 和握力有关。方法 对随访前 5 年住院的个体 (n = 1 724) 进行分析。每年通过双能 X 射线吸收测定法 (DXA) 评估 ALM 与体重指数 (BMI) 的比率 (ALMBMI)，并通过手持式测力计评估握力。在住院后的下一次年度评估时评估新的 ADL 残疾的发展情况。在下一次预定的年度评估之前，单独的回归分析模拟了院前 ALMBMI 或握力与死亡的关联。接下来，在那些幸存到下一次年度评估的人中，单独的回归分析模拟了 ALMBMI 或握力与 ADL 残疾发展之间的关联。结果 院前握力的每个标准差下降与随访时新出现 ADL 残疾的调整后 1.80 的几率相关（95% CI：1.18，2.74）。与不低相比，低握力（根据 FNIH 定义）与随访时 ADL 残疾的调整后 2.36 的几率相关（95% CI：1.12，4.97）。ALM 措施与医院相关 ADL 残疾的发生无关。ALM 和握力测量与死亡无关。结论 院前握力较低可能是老年住院幸存者 ADL 障碍的重要危险因素。