Journal of agricultural medicine and community health (농촌의학ㆍ지역보건)

Korean Society for Rural Medicine and Community Health (한국농촌의학지역보건학회)
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Nutrition and Psychosocial Factors were associated with Possible Sarcopenia in the Rural Elderly

농촌지역 주민의 영양결핍 및 사회심리적 요인과 근감소증 가능군과의 관련성

  • Kim, Bokyoung (Department of Preventive Medicine, Institute of Health Sciences, College of Medicine, Gyeongsang National University) ;
  • Lee, Gyeong-Ye (Department of Preventive Medicine, Institute of Health Sciences, College of Medicine, Gyeongsang National University) ;
  • Seo, Ae-Rim (Department of Preventive Medicine, Institute of Health Sciences, College of Medicine, Gyeongsang National University) ;
  • Kim, Mi-Ji (Department of Preventive Medicine, Institute of Health Sciences, College of Medicine, Gyeongsang National University) ;
  • Seo, Sung-Hyo (Center for Farmer's Safety and Health, Gyeongsang National University Hospital) ;
  • Park, Ki-Soo (Department of Preventive Medicine, Institute of Health Sciences, College of Medicine, Gyeongsang National University)
  • 김보경 (경상국립대학교 의과대학 예방의학교실 및 건강과학연구원) ;
  • 이경예 (경상국립대학교 의과대학 예방의학교실 및 건강과학연구원) ;
  • 서애림 (경상국립대학교 의과대학 예방의학교실 및 건강과학연구원) ;
  • 김미지 (경상국립대학교 의과대학 예방의학교실 및 건강과학연구원) ;
  • 서성효 (경상국립대학교병원 농업안전보건센터) ;
  • 박기수 (경상국립대학교 의과대학 예방의학교실 및 건강과학연구원)
  • Received : 2022.03.21
  • Accepted : 2022.06.02
  • Published : 2022.06.30
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Abstract

Objective: This study aimed to provide basic data for preventing and managing sarcopenia by identifying the relationship between sarcopenia, malnutrition, and psychosocial factors among the elderly in the community. Methods: The study included 1,019 subjects aged 60 and over. "Possible sarcopenia" was defined by low handgrip strength with or without reduced physical performance. Nutrition was evaluated according to the mini nutrition assessment (MNA), and the psychosocial factors examined were self-efficacy, social isolation, fear of falling, and social capital (trust and participation). A logistic regression analysis was also performed on the relationship between risk of malnutrition, psychosocial factors, and sarcopenia. Results: MNA was significantly associated with social participation (OR = 1.747, p <0.001), fear of falling (OR = 2.905, p <0.001), and self-efficacy (high/low, OR = 0.654, p = 0.011). In model 3, which included both MNA and psychosocial factors, sarcopenia was significantly associated with MNA (OR = 2.529, p <0.001) and fear of falling (OR = 1.544, p = 0.045). Compared with the low self-efficacy group, the high group (OR = 0.589, p = 0.009) was significant. The factors related to possible sarcopenia include risk of malnutrition, fear of falls, and low self-efficacy. Conclusion: It will be necessary to improve self-efficacy so that individuals feel they can do activities of daily living themselves and to reduce their fear of falling through muscle strength and balance exercises. Finally, it is also necessary to increase regular participation in community social activities.

연구의 목적은 지역사회 거주하고 있는 노인들의 근감소증 가능군과 영양결핍 그리고 사회심리적 요인 등과의 관련성을 파악하고자 실시되었다. 연구대상자는 농촌지역 주민 중 60세 이상인 1,019명이다. 근감소증 가능군과 관련성에 포함된 변수는 영양상태, 사회심리적 요인(낙상에 대한 두려움, 자기효능감, 사회적 고립, 사회적 자본)이다. 근감소증의 기준은 개정된 아시아 진단기준에 따라 종아리 둘레로 의심자를 찾은 다음, 악력으로 평가하였다. 연구 결과 영양은 근감소증 가능군과 관련이 있었으며 사회심리적 요인 중에서는 낙상에 대한 두려움, 자기효능감이 근감소증 가능군과 직, 간접적으로 관련이 있었으며, 사회적 자본 중 사회적 참여는 영양결핍에 직접적으로 관련이 있고, 근감소증 가능군과는 간접적으로 관련이 있었다. 결론적으로 근감소증 가능군과 관련 있는 요인으로 영양결핍과 낙상에 대한 두려움 그리고 자기효능감 저하 등이 있고 영양결핍에 사회적 참여도 관련이 있어 지역사회의 근감소증 대상 보건사업에서는 이들 변수를 고려하여 실시되어야 한다.

Keywords

References

  1. In Statistics. Korea. available from http://kosis.kr/search/search.do?query=%EB%85%B8%EC%9D%B8%EC%9D%B8%EA%B5%AC#
  2. Park HM. Current Status of Sarcopenia in Korea: A Focus on Korean Geripausal Women. Ann Geriatr Med Res. 2018;22: 52-61. doi:10.4235/agmr.2018.22.2.52
  3. Beaudart C, Biver E, Reginster J-Y, et al. Development of a self-administrated quality of life questionnaire for sarcopenia in elderly subjects: the SarQoL. Age Ageing. 2015;44(6):960-966 https://doi.org/10.1093/ageing/afv133
  4. Anker SD, Morley JE, von Haehling S. Welcome to the ICD-10 code for sarcopenia. J Cachexia Sarcopenia Muscle. 2016;7(5):512-514 https://doi.org/10.1002/jcsm.12147
  5. Falcon LJ, Harris-Love MO. Sarcopenia and the New ICD-10-CM Code: Screening, Staging, and Diagnosis Considerations. Fed Pract. 2017;34(7):24-32
  6. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31 https://doi.org/10.1093/ageing/afy169
  7. Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020;21(3):300-307.e2 https://doi.org/10.1016/j.jamda.2019.12.012
  8. Yoo JI, Ha YC, Choi H, Kim KH, Lee YK, Koo KH, et al. Malnutrition and chronic inflammation as risk factors for sarcopenia in elderly patients with hip fracture. Asia Pac J Clin Nutr. 2018;27: 527-532. doi:10.6133/apjcn.082017.02
  9. Tieland M, Trouwborst I, Clark BC. Skeletal muscle performance and ageing. J Cachexia Sarcopenia Muscle. 2018;9(1):3-19. doi:10.1002/jcsm.12238
  10. Tani Y, Sasaki Y, Haseda M, Kondo K, Kondo N. Eating alone and depression in older men and women by cohabitation status: The JAGES longitudinal survey. Age Ageing. 2015;44(6):1019-1026. doi:10.1093/ageing/afv145
  11. Boulos C, Salameh P, Barberger-Gateau P. Social isolation and risk for malnutrition among older people. Geriatrics & Gerontology International. 2017; 17(2):286-294 https://doi.org/10.1111/ggi.12711
  12. Vellas B, Villars H, Abellan G, et al. Overview of the MNA® - Its History and Challenges. J Nutr Health Aging. 2006;10:456-465
  13. Guigoz Y. The Mini-Nutritional Assessment (MNA®) Review of the Literature - What does it tell us? J Nutr Health Aging. 2006;10:466-487
  14. Lee JH, Park KS, Kim RB, Kim BJ, Chun JH. The Influence of Individual-Level Social Capitalon Depression. J Agric Med Community Health 2011;36(2):73-86 (Korean) https://doi.org/10.5393/JAMCH.2011.36.2.073
  15. Chang HK, Lee JY, Gil CR, Kim MK. Prevalence of Sarcopenia in Community-Dwelling Older Adults According to Simplified Algorithms for Sarcopenia Consensus Based on Asian Working Group for Sarcopenia. Clin Interv Aging. 2020;15:2291-2299 https://doi.org/10.2147/CIA.S281131
  16. Kim M, Won CW. Prevalence of sarcopenia in community-dwelling older adults using the definition of the European Working Group on Sarcopenia in Older People 2: findings from the Korean Frailty and Aging Cohort Study. Age Ageing. 2019;48(6):910-916 https://doi.org/10.1093/ageing/afz091
  17. Yang L, Yao X, Shen J, et al. Comparison of revised EWGSOP criteria and four other diagnostic criteria of sarcopenia in Chinese community-dwelling elderly residents. Exp Gerontol. 2020;130:110798 https://doi.org/10.1016/j.exger.2019.110798
  18. Chen Z, Ho M, Chau PH. Prevalence, Incidence, and Associated Factors of Possible Sarcopenia in Community-Dwelling Chinese Older Adults: A Population-Based Longitudinal Study. Front Med (Lausanne). 2022;8:769708 https://doi.org/10.3389/fmed.2021.769708
  19. Gao L, Jiang J, Yang M, Hao Q, Luo L, Dong B. Prevalence of Sarcopenia and Associated Factors in Chinese Community-Dwelling Elderly: Comparison Between Rural and Urban Areas. J Am Med Dir Assoc. 2015;16(11):1003.e1-1003.e10036 https://doi.org/10.1016/j.jamda.2015.07.020
  20. Donini LM, Dominguez LJ, Barbagallo M, Savina C, Castellaneta E, Cucinotta D, et al. Senile anorexia in different geriatric settings in Italy. J Nutr Health Aging 2011;15:775-781 https://doi.org/10.1007/s12603-011-0048-y
  21. Kruizenga H, van Keeken S, Weijs P, Bastiaanse L, Beijer S, Huisman-de Waal G, et al. Undernutrition screening survey in 564,063 patients: patients with a positive undernutrition screening score stay in hospital 1.4 d longer. Am J Clin Nutr 2016;103:1026-1032 https://doi.org/10.3945/ajcn.115.126615
  22. Landi F, Liperoti R, Russo A, Giovannini S, Tosato M, Barillaro C, et al. Association of anorexia with sarcopenia in a community dwelling elderly population: results from the ilSIRENTE study. Eur J Nutr 2013;52:1261-1268 https://doi.org/10.1007/s00394-012-0437-y
  23. Phillips, S.M., Chevalier, S., and Leidy, H.J. Protein "requirements" beyond the RDA: implications for optimizing health. Appl Physiol Nutr Metab. 2016;41:565-572 https://doi.org/10.1139/apnm-2015-0550
  24. Deer, R.R. and Volpi, E. Protein intake and muscle function in older adults. Curr Opin Clin Nutr Metab Care. 2015;18:248-253 https://doi.org/10.1097/MCO.0000000000000162
  25. Locher JL, Ritchie CS, Roth DL, Baker PS, Bodner EV, Allman RM. Social isolation, support, and capital and nutritional risk in an older sample: ethnic and gender differences. Social Science & Medicine. 2005; 60(4):747-761 https://doi.org/10.1016/j.socscimed.2004.06.023
  26. Boulos C, Salameh P, Barberger-Gateau P. Social isolation and risk for malnutrition among older people. Geriatrics & Gerontology International. 2017; 17(2):286-294 https://doi.org/10.1111/ggi.12711
  27. Rosengren KS, McAuley E, Mihalko SL. Gait adjustments in older adults: activity and efficacy influences. Psychol Aging 1998;13:375-386 https://doi.org/10.1037/0882-7974.13.3.375
  28. McAuley E, Konopack JF, Morris KS, Motl RW, Hu L, Doerksen SE, et al. Physical activity and functional limitations in older women: influence of self-efficacy. J Gerontol B Psychol Sci Soc Sci 2006;61:270-P277
  29. Cheung C, Wyman JF, Savik K. Adherence to a yoga program in older women with knee osteoarthritis. J Aging Phys Act 2016;24:181-188 https://doi.org/10.1123/japa.2015-0048
  30. McAuley E, Morris KS, Doerksen SE, Motl RW, Liang H, White SM, et al. Effects of change in physical activity on physical function limitations in older women: mediating roles of physical function performance and self-efficacy. J Am Geriatr Soc 2007;55:1967-1973 https://doi.org/10.1111/j.1532-5415.2007.01469.x
  31. McAuley E, Blissmer B. Self-efficacy determinants and consequences of physical activity. Exerc Sport Sci Rev 2000;28:85-88
  32. Rejeski WJ, Ettinger WH Jr, Martin K, Morgan T. Treating disability in knee osteoarthritis with exercise therapy: a central role for self-efficacy and pain. Arthritis Care Res 1998;11:94-101 https://doi.org/10.1002/art.1790110205
  33. Li F, Harmer P, McAuley E, Fisher KJ, Duncan TE, Duncan SC. Tai Chi, self-efficacy, and physical function in the elderly. Prev Sci 2001;2:229-239 https://doi.org/10.1023/A:1013614200329
  34. Cumming RG, Salkeld G, Thomas M, Szonyi G. Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. J Gerontol A Biol Sci Med Sci 2000;55:M299-M305 https://doi.org/10.1093/gerona/55.5.M299
  35. Brouwer B, Musselman K, Culham E. Physical function and health status among seniors with and without a fear of falling. Gerontology 2004;50:135-141 https://doi.org/10.1159/000076771
  36. Jefferis BJ, Iliffe S, Kendrick D, Kerse N, Trost S, Lennon LT, et al. How are falls and fear of falling associated with objectively measured physical activity in a cohort of community-dwelling older men? BMC Geriatr 2014;14:114 https://doi.org/10.1186/1471-2318-14-114
  37. Stenholm S, Koster A, Valkeinen H, Patel KV, Bandinelli S, Guralnik JM, et al. Association of physical activity history with physical function and mortality in old age. J Gerontol A Biol Sci Med Sci 2016;71:496-501 https://doi.org/10.1093/gerona/glv111