Background Activities of daily living (ADLs) and instrumental activities of daily living (IADLs) are essential for independent living and are predictors of morbidity and mortality in older populations. Older adults who are dependent in ADLs and IADLs are also more likely to have poor muscle measures defined as low muscle mass, muscle strength, and physical performance, which further limit their ability to perform activities. The aim of this systematic review and meta-analysis was to determine if muscle measures are predictive of ADL and IADL in older populations. Methods A systematic search was conducted using four databases (MEDLINE, EMBASE, Cochrane, and CINAHL) from date of inception to 7 June 2018. Longitudinal cohorts were included that reported baseline muscle measures defined by muscle mass, muscle strength, and physical performance in conjunction with prospective ADL or IADL in participants aged 65 years and older at follow-up. Meta-analyses were conducted using a random effect model. Results Of the 7760 articles screened, 83 articles were included for the systematic review and involved a total of 108 428 (54.8% female) participants with a follow-up duration ranging from 11 days to 25 years. Low muscle mass was positively associated with ADL dependency in 5/9 articles and 5/5 for IADL dependency. Low muscle strength was associated with ADL dependency in 22/34 articles and IADL dependency in 8/9 articles. Low physical performance was associated with ADL dependency in 37/49 articles and with IADL dependency in 9/11 articles. Forty-five articles were pooled into the meta-analyses, 36 reported ADL, 11 reported IADL, and 2 reported ADL and IADL as a composite outcome. Low muscle mass was associated with worsening ADL (pooled odds ratio (95% confidence interval) 3.19 (1.29-7.92)) and worsening IADL (1.28 (1.02-1.61)). Low handgrip strength was associated with both worsening ADL and IADL (1.51 (1.34-1.70); 1.59 (1.04-2.31) respectively). Low scores on the short physical performance battery and gait speed were associated with worsening ADL (3.49 (2.47-4.92); 2.33 (1.58-3.44) respectively) and IADL (3.09 (1.06-8.98); 1.93 (1.69-2.21) respectively). Low one leg balance (2.74 (1.31-5.72)), timed up and go (3.41 (1.86-6.28)), and chair stand test time (1.90 (1.63-2.21)) were associated with worsening ADL. Conclusions Muscle measures at baseline are predictors of future ADL and IADL dependence in the older adult population.

中文翻译：

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预测日常生活活动的肌肉质量、力量和身体表现：一项荟萃分析。


背景 日常生活活动（ADL）和工具性日常生活活动（IADL）对于独立生活至关重要，并且是老年人群发病率和死亡率的预测因子。依赖 ADL 和 IADL 的老年人也更有可能有较差的肌肉测量值，定义为低肌肉质量、肌肉力量和身体表现，这进一步限制了他们进行活动的能力。本系统评价和荟萃分析的目的是确定肌肉测量值是否可以预测老年人群的 ADL 和 IADL。方法 使用四个数据库（MEDLINE、EMBASE、Cochrane 和 CINAHL）从成立之日起至 2018 年 6 月 7 日进行系统搜索。纵向队列包括报告的基线肌肉测量值，这些测量值由肌肉质量、肌肉力量和身体表现共同定义。随访时对 65 岁及以上参与者进行前瞻性 ADL 或 IADL 评估。使用随机效应模型进行荟萃分析。结果 筛选的 7760 篇文章中，纳入 83 篇文章进行系统评价，共涉及 108 428 名参与者（54.8% 女性），随访时间从 11 天到 25 年不等。 5/9 的文章中低肌肉质量与 ADL 依赖呈正相关，5/5 与 IADL 依赖呈正相关。在 22/34 篇文章中，低肌肉力量与 ADL 依赖相关，在 8/9 篇文章中，低肌力与 ADL 依赖相关。在 37/49 篇文章中，低身体表现与 ADL 依赖相关；在 9/11 篇文章中，低身体表现与 IADL 依赖相关。荟萃分析汇集了 45 篇文章，其中 36 篇报道了 ADL，11 篇报道了 IADL，2 篇报道了 ADL 和 IADL 作为综合结果。低肌肉质量与 ADL 恶化相关（合并比值比（95% 置信区间）3。19 (1.29-7.92)) 和 IADL 恶化 (1.28 (1.02-1.61))。低握力与 ADL 和 IADL 恶化相关（分别为 1.51 (1.34-1.70)；1.59 (1.04-2.31)）。短身体表现电池和步态速度的低分与 ADL 恶化（分别为 3.49（2.47-4.92）；2.33（1.58-3.44））和 IADL（分别为 3.09（1.06-8.98）；1.93（1.69-2.21））相关。 。单腿平衡能力低（2.74（1.31-5.72））、计时起立（3.41（1.86-6.28））和椅子站立测试时间（1.90（1.63-2.21））与ADL恶化相关。结论 基线肌肉测量值是老年人群未来 ADL 和 IADL 依赖性的预测指标。