Article(id=1323941329180438585, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1323941237702668764, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202506248, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1749744000000, receivedDateStr=2025-06-13, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793581810516, onlineDateStr=2026-11-02, pubDate=1765296000000, pubDateStr=2025-12-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793581810516, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793581810516, creator=13701087609, updateTime=1793581810516, updator=13701087609, issue=Issue{id=1323941237702668764, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='23', pageStart='4225', pageEnd='4416', issueExtLink='null', onlineDate='null', pubDate='1765296000000', pubDateStr='2025-12-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793581788707, creator='13701087609', updateTime=1793581887795, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1323941653374959780, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1323941237702668764, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1323941653374959781, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1323941237702668764, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=4326, endPage=4331, ext={EN=ArticleExt(id=1323941329465651258, articleId=1323941329180438585, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Association between motoric cognitive risk syndrome and sarcopenia among rural older adults and the moderating effects of lifestyle behaviors, columnId=1228016572892119056, journalTitle=Modern Preventive Medicine, columnName=Primary Health Services, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the associations between motoric cognitive risk syndrome(MCR) and its parameters with sarcopenia among elderly individuals in rural areas, and the moderating effect of lifestyle behaviors (physical activity, alcohol consumption, smoking) on the relationship between MCR and sarcopenia, to provide a scientific basis for developing targeted intervention strategies and preventive measures.

Methods

A convenience sampling method was employed, and 652 elderly participants were recruited from rural regions of Anhui Province for this study. MCR was assessed by a combination of subjective cognitive decline and slow gait, and sarcopenia was assessed by Sarcopenia Five(SARC-F). The regression method was used to analyze the correlation between MCR and its parameters and sarcopenia, and the moderating role of lifestyle behaviors in the above correlation was analyzed.

Results

Older adults with MCR had higher SARC-F scores (β=0.819, P<0.05), and had a higher risk of developing sarcopenia (OR=1.794, P<0.05). Stratified analysis revealed that lifestyle behaviors significantly moderated the association between MCR and sarcopenia, with the effect of MCR on sarcopenia risk being more pronounced among individuals who did not exercise, did not consume alcohol, and did not smoke.

Conclusion

MCR is associated with a higher risk of sarcopenia, and exercise, alcohol consumption, and smoking have a moderating effect on the above associations.

, authors=Qing-zhou MENG1, Yan ZHANG1, Lun-fang XIE2, Jia-jia CHENG1, Tian-tian WANG1, Zhi-nan GAO1, authorsList=Qing-zhou MENG, Yan ZHANG, Lun-fang XIE, Jia-jia CHENG, Tian-tian WANG, Zhi-nan GAO, authorCompany=null, correspAuthors=Yan ZHANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1323941332028371009, articleId=1323941329180438585, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=农村老年人运动认知风险综合征与肌少症的相关性及行为生活方式的调节效应, columnId=1228016573533847611, journalTitle=现代预防医学, columnName=基层卫生服务, runingTitle=null, highlight=null, articleAbstract=
目的

探讨农村老年人运动认知风险综合征(motoric cognitive risk syndrome, MCR)与其参数和肌少症之间的相关性,以及行为生活方式(运动、饮酒、吸烟)在上述关系中的调节效应,为制定有针对性的干预策略和预防措施提供依据。

方法

采用方便抽样,从安徽省农村地区抽取652名老年人进行调查,MCR通过主观认知下降和步速缓慢来综合评估,肌少症通过肌少症五条目量表(sarcopenia five, SARC-F)来评估。采用回归方法分析MCR及其参数与肌少症的相关性,并分析行为生活方式在其中的调节作用。

结果

患有MCR的老年人SARC-F得分更高(β=0.819,P<0.05),患肌少症风险也较高(OR=1.794, P<0.05)。分层分析结果显示,行为生活方式在MCR与肌少症关系中存在显著调节作用,尤其在无运动、不饮酒和不吸烟人群中,MCR对肌少症的风险影响更为显著。

结论

MCR与较高的肌少症风险相关,运动、饮酒、吸烟在上述相关性中具有一定的调节效应。

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孟庆洲(2001—),男,硕士在读,研究方向:社会医学

, correspAuthorsNote=
张燕,E-mail:
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Clinical Interventions in Aging, 2025, 20: 161-170., articleTitle=Effect of exercise and nutrition intervention for older adults with impaired physical function with preserved muscle mass(functional sarcopenia): a randomized controlled trial, refAbstract=null), Reference(id=1323941342522519703, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941329180438585, doi=null, pmid=null, pmcid=null, year=2024, volume=12, issue=2, pageStart=197, pageEnd=null, url=null, language=null, rfNumber=[26], rfOrder=30, authorNames=Choi Y, Kim D, Kim SK, journalName=HEALTHCARE, refType=null, unstructuredReference=Choi Y, Kim D, Kim SK. Effects of physical activity on body composition, muscle strength, and physical function in old age:bibliometric and Meta-Analyses [J]. HEALTHCARE, 2024, 12 (2): 197., articleTitle=Effects of physical activity on body composition, muscle strength, and physical function in old age:bibliometric and Meta-Analyses, refAbstract=null), Reference(id=1323941342623183000, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941329180438585, doi=null, pmid=null, pmcid=null, year=2022, volume=35, issue=2, pageStart=197, pageEnd=206, url=null, language=null, rfNumber=[27], rfOrder=31, authorNames=Prokopidis K, Witard OC, journalName=Nutrition Research Reviews, refType=null, unstructuredReference=Prokopidis K, Witard OC. Understanding the role of smoking and chronic excess alcohol consumption on reduced caloric intake and the development of sarcopenia [J]. 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注:A为运动,调整了年龄、性别、文化程度、饮酒、吸烟、衰弱状态、社会隔离状态、ADL;B为饮酒,调整了年龄、性别、文化程度、运动、吸烟、衰弱状态、社会隔离状态、ADL;C为吸烟,调整了年龄、性别、文化程度、运动、饮酒、衰弱状态、社会隔离状态、ADL。

, figureFileSmall=Y2QrkzQXhJQNnVYuOGsApA==, figureFileBig=7Mg45RMqK3JA2/8UtHzP6Q==, tableContent=null), ArticleFig(id=1323941337392885871, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941329180438585, language=EN, label=Table 1, caption=

Basic characteristics of the research object [(), n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
基本特征合计(n=619)非肌少症(n=420)肌少症(n=199)t/χ2值P值
年龄(岁)71.52±6.7770.47±6.5173.75±6.805.683<0.001
性别
男性281220(78.29)61(21.71)25.716<0.001
女性338200(59.17)138(40.83)
文化程度
文盲381239(62.73)142(37.27)0.006a
小学13699(72.79)37(27.21)—
初中6854(79.41)14(20.59)
高中或中专3226(81.25)6(18.75)
大学及以上22(100)0(0.00)
社会隔离
否356267(75.00)89(25.00)19.629<0.001
是263153(58.17)110(41.83)
饮酒
否489309(63.19)180(36.81)23.191<0.001
是130111(85.38)19(14.62)
吸烟
否502326(64.94)176(35.04)10.3180.001
是11794(80.34)23(19.66)
运动
否17098(57.65)72(42.35)11.1880.001
是449322(71.71)127(28.29)
ADL评分(分)94.22±7.6788.66±10.3396.86±3.82-14.342<0.001
衰弱状态
否20187(43.38)114(56.72)82.361<0.001
是418333(79.67)85(20.33)
MCR
否513379(73.88)134(26.12)49.899<0.001
是10641(38.68)65(61.32)
), ArticleFig(id=1323941337468383344, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941329180438585, language=CN, label=表1, caption=

研究对象的基本特征[(),n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
基本特征合计(n=619)非肌少症(n=420)肌少症(n=199)t/χ2值P值
年龄(岁)71.52±6.7770.47±6.5173.75±6.805.683<0.001
性别
男性281220(78.29)61(21.71)25.716<0.001
女性338200(59.17)138(40.83)
文化程度
文盲381239(62.73)142(37.27)0.006a
小学13699(72.79)37(27.21)—
初中6854(79.41)14(20.59)
高中或中专3226(81.25)6(18.75)
大学及以上22(100)0(0.00)
社会隔离
否356267(75.00)89(25.00)19.629<0.001
是263153(58.17)110(41.83)
饮酒
否489309(63.19)180(36.81)23.191<0.001
是130111(85.38)19(14.62)
吸烟
否502326(64.94)176(35.04)10.3180.001
是11794(80.34)23(19.66)
运动
否17098(57.65)72(42.35)11.1880.001
是449322(71.71)127(28.29)
ADL评分(分)94.22±7.6788.66±10.3396.86±3.82-14.342<0.001
衰弱状态
否20187(43.38)114(56.72)82.361<0.001
是418333(79.67)85(20.33)
MCR
否513379(73.88)134(26.12)49.899<0.001
是10641(38.68)65(61.32)
), ArticleFig(id=1323941337556463729, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941329180438585, language=EN, label=Table 2, caption=

Linear regression analysis of MCR and its parameters and SARC-F scores

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2模型3
β(95% CI)P值β(95% CI)P值β(95% CI)P值
MCR
否对照组对照组对照组
是2.049(1.580~2.518)<0.0011.622(1.193~2.131)<0.0010.819(0.408~1.230)<0.001
主观认知下降
否对照组对照组对照组
是0.487(0.023~0.952)0.0400.131(-0.316~0.578)0.5660.019(-0.394~0.382)0.920
步速缓慢
否对照组对照组对照组
是2.120(1.783~2.456)<0.0011.816(1.464~2.618)<0.0010.723(0.384~1.062)<0.001
), ArticleFig(id=1323941337631961202, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941329180438585, language=CN, label=表2, caption=

MCR及其参数与SARC-F得分的线性回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2模型3
β(95% CI)P值β(95% CI)P值β(95% CI)P值
MCR
否对照组对照组对照组
是2.049(1.580~2.518)<0.0011.622(1.193~2.131)<0.0010.819(0.408~1.230)<0.001
主观认知下降
否对照组对照组对照组
是0.487(0.023~0.952)0.0400.131(-0.316~0.578)0.5660.019(-0.394~0.382)0.920
步速缓慢
否对照组对照组对照组
是2.120(1.783~2.456)<0.0011.816(1.464~2.618)<0.0010.723(0.384~1.062)<0.001
), ArticleFig(id=1323941337703264371, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941329180438585, language=EN, label=Table 3, caption=

Logistic regression analysis of MCR and its parameters and sarcopenia

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2模型3
OR(95% CI)P值OR(95% CI)P值OR(95% CI)P值
MCR
否对照组对照组对照组
是4.484(2.894~6.946)<0.0013.486(2.194~5.539)<0.0011.794(1.022~3.151)0.042
主观认知下降
否对照组对照组对照组
是1.611(1.074~2.416)0.0211.235(0.804~1.896)0.3351.312(0.785~2.193)0.300
步速缓慢
否对照组对照组对照组
是6.431(4.395~9.409)<0.0015.159(3.454~7.706)<0.0012.006(1.246~3.228)0.004
), ArticleFig(id=1323941337799733364, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941329180438585, language=CN, label=表3, caption=

MCR及其成分与肌少症的logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2模型3
OR(95% CI)P值OR(95% CI)P值OR(95% CI)P值
MCR
否对照组对照组对照组
是4.484(2.894~6.946)<0.0013.486(2.194~5.539)<0.0011.794(1.022~3.151)0.042
主观认知下降
否对照组对照组对照组
是1.611(1.074~2.416)0.0211.235(0.804~1.896)0.3351.312(0.785~2.193)0.300
步速缓慢
否对照组对照组对照组
是6.431(4.395~9.409)<0.0015.159(3.454~7.706)<0.0012.006(1.246~3.228)0.004
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农村老年人运动认知风险综合征与肌少症的相关性及行为生活方式的调节效应
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孟庆洲 1 , 张燕 1 , 谢伦芳 2 , 成家佳 1 , 王甜甜 1 , 高治楠 1
现代预防医学 | 基层卫生服务 2025,52(23): 4326-4331
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现代预防医学 |基层卫生服务 2025 , 52 (23) : 4326 -4331
农村老年人运动认知风险综合征与肌少症的相关性及行为生活方式的调节效应
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孟庆洲1, 张燕1 , 谢伦芳2, 成家佳1, 王甜甜1, 高治楠1
作者信息
  • 1.安徽医科大学卫生管理学院,安徽 合肥 230032
  • 2.安徽医科大学护理学院
通讯作者:
张燕,E-mail:
作者简介:

孟庆洲(2001—),男,硕士在读,研究方向:社会医学

Association between motoric cognitive risk syndrome and sarcopenia among rural older adults and the moderating effects of lifestyle behaviors
Qing-zhou MENG1, Yan ZHANG1 , Lun-fang XIE2, Jia-jia CHENG1, Tian-tian WANG1, Zhi-nan GAO1
Affiliations
  • School of Health Service Management, Anhui Medical University, Hefei, Anhui 230032, China
出版时间: 2025-12-10 doi: 10.20043/j.cnki.MPM.202506248
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目的

探讨农村老年人运动认知风险综合征(motoric cognitive risk syndrome, MCR)与其参数和肌少症之间的相关性,以及行为生活方式(运动、饮酒、吸烟)在上述关系中的调节效应,为制定有针对性的干预策略和预防措施提供依据。

方法

采用方便抽样,从安徽省农村地区抽取652名老年人进行调查,MCR通过主观认知下降和步速缓慢来综合评估,肌少症通过肌少症五条目量表(sarcopenia five, SARC-F)来评估。采用回归方法分析MCR及其参数与肌少症的相关性,并分析行为生活方式在其中的调节作用。

结果

患有MCR的老年人SARC-F得分更高(β=0.819,P<0.05),患肌少症风险也较高(OR=1.794, P<0.05)。分层分析结果显示,行为生活方式在MCR与肌少症关系中存在显著调节作用,尤其在无运动、不饮酒和不吸烟人群中,MCR对肌少症的风险影响更为显著。

结论

MCR与较高的肌少症风险相关,运动、饮酒、吸烟在上述相关性中具有一定的调节效应。

运动认知风险综合征  /  肌少症  /  生活方式  /  调节作用
Objective

To investigate the associations between motoric cognitive risk syndrome(MCR) and its parameters with sarcopenia among elderly individuals in rural areas, and the moderating effect of lifestyle behaviors (physical activity, alcohol consumption, smoking) on the relationship between MCR and sarcopenia, to provide a scientific basis for developing targeted intervention strategies and preventive measures.

Methods

A convenience sampling method was employed, and 652 elderly participants were recruited from rural regions of Anhui Province for this study. MCR was assessed by a combination of subjective cognitive decline and slow gait, and sarcopenia was assessed by Sarcopenia Five(SARC-F). The regression method was used to analyze the correlation between MCR and its parameters and sarcopenia, and the moderating role of lifestyle behaviors in the above correlation was analyzed.

Results

Older adults with MCR had higher SARC-F scores (β=0.819, P<0.05), and had a higher risk of developing sarcopenia (OR=1.794, P<0.05). Stratified analysis revealed that lifestyle behaviors significantly moderated the association between MCR and sarcopenia, with the effect of MCR on sarcopenia risk being more pronounced among individuals who did not exercise, did not consume alcohol, and did not smoke.

Conclusion

MCR is associated with a higher risk of sarcopenia, and exercise, alcohol consumption, and smoking have a moderating effect on the above associations.

Motoric cognitive risk syndrome  /  Sarcopenia  /  Lifestyle  /  Moderating effect
孟庆洲, 张燕, 谢伦芳, 成家佳, 王甜甜, 高治楠. 农村老年人运动认知风险综合征与肌少症的相关性及行为生活方式的调节效应. 现代预防医学, 2025 , 52 (23) : 4326 -4331 . DOI: 10.20043/j.cnki.MPM.202506248
Qing-zhou MENG, Yan ZHANG, Lun-fang XIE, Jia-jia CHENG, Tian-tian WANG, Zhi-nan GAO. Association between motoric cognitive risk syndrome and sarcopenia among rural older adults and the moderating effects of lifestyle behaviors[J]. Modern Preventive Medicine, 2025 , 52 (23) : 4326 -4331 . DOI: 10.20043/j.cnki.MPM.202506248
运动认知风险综合征(motoric cognitive risk syndrome, MCR)与肌肉减少症(简称肌少症)是老年人群中两种常见的疾病,严重影响老年人的健康状态和生活质量。MCR已被证实是痴呆的早期风险因素,其特征是存在主观认知下降和步速缓慢,但尚无痴呆或行动不便[1]。有研究表明,患有MCR的个体患认知障碍和痴呆的风险相较于不患MCR的个体增加了2.20倍[2]。肌少症是一种与增龄相关的老年综合征,主要表现为肌肉质量和力量下降以及躯体功能障碍[3],在全球60岁及以上老年人群中的患病率为10%~27%[4]。肌少症显著增加跌倒、衰弱、残疾的风险,带来沉重的医疗和照护负担,尤其在农村地区老年人的患病率高于城市地区[5]。
值得关注的是,近年来多项研究开始探索MCR与肌少症之间的潜在关联机制。尽管两者属于不同系统疾病,但均涉及慢性炎症、代谢紊乱、氧化应激和神经肌肉功能障碍等共同的病理过程[6-8]。此外,有研究表明,行为生活方式对老年人的认知和运动功能均具有重要影响,良好的生活方式可能通过改善神经可塑性和肌肉代谢,延缓认知衰退和肌少症的发生[9]。然而,目前关于农村老年人中MCR与肌少症之间是否存在相关性,以及行为生活方式是否在其中发挥调节作用,尚有待于进一步研究。有鉴于此,本研究拟探讨农村老年人MCR与肌少症的相关性,以及常见的行为生活方式在其中的调节效应,以期为农村地区肌少症的早期预防提供依据。
本研究采用方便抽样的方法,以安徽省霍山县及临泉县的农村老年人为研究对象进行调查,纳入标准:(1)年龄≥60岁;(2)本地区常住居民或在该地区居住六个月以上;(3)无明显的痴呆或行动障碍。本研究共调查652名老年人,经排除不符合要求问卷后,共有619份问卷进入分析阶段。所有研究对象在知情同意的前提下接受调查。本研究方案已获安徽医科大学生物医学伦理委员会审批(批号:83220201)。
采用自编问卷收集以下信息:(1)社会人口学特征:年龄、性别及文化程度。(2)行为生活方式:包括运动、饮酒和吸烟,其中运动情况根据问卷条目“您是否有规律性的运动习惯”进行判定。饮酒、吸烟情况根据问卷条目 “您现在是否饮酒”“您现在是否吸烟”进行判定。(3)日常生活能力:采用日常生活活动(activities of daily living,ADL)量表评估个体的日常生活能力,总分为0~100分,得分越高表示独立性越强,自理能力越强[10]。(4)社会隔离:鉴于社会隔离与老年人认知功能和身体状态密切相关[11],本研究采用Lubben社会网络量表(the Lubben social network scale-6,LSNS-6)评定个体是否有社会隔离,该量表总分为0~30分,当总分<12分时,表明个体存在社会隔离[12]。(5)衰弱:衰弱可能在认知与身体退化过程中发挥中介或协同作用[13],故本研究根据Fried衰弱评定(Fried frailty phenotype,FFP)量表评定个体是否衰弱,量表总分为0~5分,本研究将FFP量表得分在3分及以上定义为有衰弱,反之认为没有衰弱[14]。
(1)MCR:鉴于该概念尚无国际统一的诊断标准,但其核心构成(主观认知下降与步速缓慢)已在多项研究中被广泛采用并验证,本研究参考Verghese等对MCR的原始定义,并结合马丽娜等 [15]关于MCR在中国老年人群体中的应用研究,将MCR界定为“无明显痴呆或运动障碍,且同时存在主观认知下降与步速缓慢”。其标准如下:①主观认知下降:采用简易精神状态检查(mini-mental state examination,MMSE)中瞬时记忆维度作为主观认知下降条目,该条目0~3分,若研究对象得分小于3分,则判定为主观认知下降[16]。②步速缓慢:以4 m步速测定法进行步速评估,根据亚洲肌少症工作组建议,研究对象平均步速<1.0m/s即被判定为步速缓慢[17]。(2)肌少症:采用汉化版肌少症5条目量表(sarcopenia-five,SARC-F),总分为0~10分,SARC-F总分≥4分被判定为肌少症,而<4分则判定为非肌少症。该量表的灵敏度为71.4% ~76.9%[18]。
采用多模型策略逐步控制纳入的混杂因素,在正态性检验的基础上,采用线性回归对MCR及其参数与SARC-F得分进行分析,并采用二元logistic回归分析MCR及其参数与肌少症之间的关系。在调节效应分析中,本研究同时纳入了社会人口学变量(如年龄、性别等)及行为生活方式变量,采用中心化后的自变量与调节变量的乘积项作为交互项,纳入回归模型进行调节效应检验。经调整混杂因素后,结果显示社会人口学变量的调节效应均未达到显著水平(P均>0.05),因此仅对调节效应显著的三种行为生活方式变量进行了分层分析,以进一步明确其调节模式。使用SPSS 25.0和Stata 18.0进行数据分析,绘图采用R 4.3.1完成。所有统计检验均采用双侧检验,显著性水平设定为α=0.05。
619名研究对象中,199人(32.15%)被判定为肌少症。研究对象平均年龄为71.52岁;女性338名(54.60%),男性281名(45.40%);381名研究对象是文盲(61.55%),此外356名老年人没有社会隔离(57.51%);在619名老年人群中,502人(81.10%)不吸烟,489人(79.00%)不饮酒。肌少症与非肌少症患者在年龄、性别、文化程度、社会隔离、吸烟、饮酒、运动、ADL、衰弱和MCR的差异均具有统计学意义(P<0.05)。见表1。
如表2所示,在模型3中,相较于不患MCR的研究对象,患有MCR的研究对象SARC-F得分更高(β=0.819,P<0.05)。在MCR的参数中,存在步速缓慢的人具有更高的SARC-F得分(β=0.723, P<0.05),但在主观认知下降中,差异并不具有统计学意义。见表2。
如表3所示,在模型3中,相较于不患MCR的研究对象,患有MCR的研究对象更容易患肌少症(OR=1.794,P<0.05),存在步速缓慢的老年人也更容易患肌少症(OR=2.006,P<0.05),但在主观认知下降中,差异并不具有统计学意义。见表3。
针对调节效应显著的三种行为生活方式变量开展分层分析,结果表明,在运动分层中,“无运动”组内,MCR与肌少症风险显著相关(OR=3.899,P<0.05),而在“有运动”组中未观察到类似显著关联。在饮酒分层中,“不饮酒”组中, MCR是肌少症的显著危险因素(OR=2.059,P<0.05)。在吸烟分层中,“不吸烟”组内,患有MCR的个体SARC-F量表得分更高(β=0.992,P<0.05),且患肌少症的风险也显著升高(OR=2.254,P<0.05);同时,不吸烟者步速缓慢也与更高的肌少症风险相关(OR=2.038,P<0.05)。见图1。
本研究结果显示,在安徽省农村老年人中,MCR与肌少症具有相关性,患有MCR的老年人肌少症的风险更高,运动、饮酒、吸烟在二者之间具有调节效应。肌少症作为常见的老年疾病,往往与多种不良结局有关。因此,通过研究MCR与肌少症之间的关系以及行为生活方式在二者之间的调节效应,可以更早地识别发现肌少症患者,为实现老年人健康老龄化提供新思路。
本研究发现,60岁以上农村老年人口MCR患病率为17.12%,这一结果略微高于宋佳等人[19]的研究,这种差异可能是由于本研究所纳入人群的整体文化程度较低(文盲占61.55%)所导致。此外,本研究的肌少症患病率为32.15%,这一结果高于孟世龙等人[20]的研究,这种差异可能是与所选择的肌少症的判断标准不同有关。本研究采用简便易行的汉化SARC-F量表作为筛查工具,适用于医疗资源相对匮乏的农村地区,可避免对昂贵医疗设备的依赖,提升了筛查的可操作性,具有早期识别肌少症的实用价值[21]。
MCR与肌少症存在关联可能有以下原因:(1)身体活动减少:MCR患者由于认知功能下降和步速缓慢,可能会有一定程度的行动限制,往往会减少身体活动,从而导致肌肉萎缩进而引起肌少症[22]。(2)共同的病理生理机制:MCR和肌少症可能具有一些共同的病理生理机制,如神经肌肉功能障碍、慢性炎症等[6]。(3)年龄增长:已有相当多的研究表明,随着年龄增长,认知功能和肌肉质量均自然下降[23]。
此外,既往研究表明,行为生活方式与慢性病密切相关[24]。本研究进一步发现,在运动、饮酒和吸烟的不同行为分层中,MCR与肌少症之间的关联存在差异,提示行为生活方式可能在其中具有调节作用。具体而言,在无规律运动、不饮酒和不吸烟人群中,MCR对肌少症的风险影响更为显著。值得注意的是,虽然运动通常被认为能够改善肌肉质量与功能,尤其是抗阻训练可能促进肌肉蛋白合成并延缓肌肉衰减[25],但本研究结果提示,在存在MCR的前提下,运动者的肌肉功能变化可能更容易被检测到或表现得更明显,这或与其肌肉系统反应性较高有关。相反,在不饮酒或不吸烟人群中,MCR与肌少症的关联也更为显著,这与传统观点存在一定差异,可能反映出这些行为在神经肌肉功能中的复杂调节路径。例如,MCR可能通过影响神经肌肉连接或运动单位激活来损害肌肉功能,而吸烟可能通过诱发慢性炎症反应和氧化应激来干扰这一过程[26]。同样,酒精过量摄入则可能影响蛋白质合成和营养吸收,甚至对肌肉产生直接毒性作用[27],可能对MCR与肌少症的关系路径产生干扰。此外,样本结构异质性、行为变量定义的简化、混杂因素的调整策略等也可能影响调节效应的稳定性。因此,未来研究应进一步细化行为生活方式的测量,并明确其在MCR与肌少症关系中的具体机制。
本研究尚有以下局限性:第一,本研究为横断面研究,因此无法推断MCR与肌少症之间的因果关系,且只局限于安徽省两地区农村老年人,未来的研究应考虑大样本、多中心的前瞻性队列研究,进一步验证本研究的发现。第二,本研究采用SARC-F量表这一筛查工具,虽然在医疗资源相对匮乏的农村地区有简便易行的优势,但这种非诊断性工具不能完全避免错分偏倚。第三,本研究仅评估了是否运动、饮酒、吸烟等常见行为生活方式因素,未进一步收集运动频率、强度、时长及烟酒摄入量等详细信息。未来研究应在更高质量的数据基础上,纳入多维度行为生活方式指标,以深入分析其对 MCR 与肌少症关系的潜在调节效应。第四,目前MCR尚无统一的诊断标准,本研究依据主观认知下降与步速缓慢的组合标准进行评估,可能存在一定主观性及文化背景差异的影响。未来研究应基于多中心大样本数据,探索更为客观、标准化的MCR诊断方法。
本研究提示,在农村老年人中MCR是肌少症的重要危险因素,同时行为生活方式(运动、饮酒、吸烟)在MCR与肌少症的关系中起显著的调节作用。应加强对农村老年人MCR的早期筛查与干预,尽早识别高风险个体,采取针对MCR及行为生活方式的综合干预措施,延缓肌少症的发生和发展。考虑到现有研究对健康生活方式的普遍支持,未来研究还应进一步明确不同生活方式因素在预防和干预MCR及肌少症中的具体作用和机制,为改善农村老年人的认知和肌肉健康提供科学依据。
  • 国家自然科学基金青年基金(72004003)
  • 老年长期照护教育部重点实验室(海军军医大学)培育项目(LNYBPY-2023-05)
  • 安徽省循证医学学会创新研究课题(AHEMB2409)
  • 安徽省科研计划编制项目(自然科学研究重点)(2024AH05070 8)
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2025年第52卷第23期
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doi: 10.20043/j.cnki.MPM.202506248
  • 接收时间:2025-06-13
  • 首发时间:2026-11-02
  • 出版时间:2025-12-10
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  • 收稿日期:2025-06-13
基金
国家自然科学基金青年基金(72004003)
老年长期照护教育部重点实验室(海军军医大学)培育项目(LNYBPY-2023-05)
安徽省循证医学学会创新研究课题(AHEMB2409)
安徽省科研计划编制项目(自然科学研究重点)(2024AH05070 8)
作者信息
    1.安徽医科大学卫生管理学院,安徽 合肥 230032
    2.安徽医科大学护理学院

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张燕,E-mail:
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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