Sarcopenia as a Predictor of Hospital-Associated Disability in Older Adults

肌肉减少症是老年人医院相关残疾的预测因素

基本信息

批准号：
10162768
负责人：
James Andrews
金额：
$ 19.82万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-15 至 2023-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10162768
关键词：
2019-nCoV Activities of Daily Living Acute Address Administrative Supplement Admission activity Adverse effects Adverse event Affect Age Alzheimer&apos s Disease Alzheimer&apos s disease related dementia Award Body Composition COVID-19 COVID-19 pandemic Characteristics Dementia Development Dual-Energy X-Ray Absorptiometry Elderly Enrollment Fatigue Funding Grant Hospitalization Hospitals Individual Infrastructure Intervention Knowledge Manuals Measures Medical Mentored Patient-Oriented Research Career Development Award Mission Muscle Outcome Parents Participant Pathogenesis Patient Self-Report Patients Persons Pharmaceutical Preparations Physical Function Physical Performance Pneumonia Prospective cohort study Public Health Questionnaires Research Research Infrastructure Risk Risk Factors Sepsis Survivors Symptoms Telephone Interviews Testing Ultrasonography adverse outcome clinical risk cohort comorbidity cost disability experience frailty functional decline functional outcomes health assessment muscle form muscle strength physical conditioning physically handicapped prevent sarcopenia young adult

项目摘要

PROJECT SUMMARY/ABSTRACT At least half of all physical disability among older adults develops in the setting of an acute hospitalization, and those with Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD) are at particular risk for physical disability after an acute hospitalization. Older adults hospitalized for specific illnesses, such as pneumonia and sepsis, are particularly at risk for developing new physical disability. During the COVID-19 pandemic, older adults, compared to younger adults, are also at greater risk of developing more severe COVID-19, including greater risk of needing to be hospitalized, of requiring ICU admission, and of developing pneumonia and sepsis. As of May 6, 2020, over 3.7 million individuals throughout the world have developed COVID-19, of which over 258,000 have died. Given the historic scale of the COVID-19 pandemic, the increased burden of physical disability associated with COVID-19 is very likely to have a vast public health impact, particularly among older adults and those with AD/ADRD. However, little is known about the functional outcomes of COVID-19, especially among older adults and those with AD/ADRD who are most likely to be adversely affected. Addressing this key knowledge gap is critical in identifying key clinical risk factors for adverse outcomes, informing understanding of pathogenesis of physical disability after COVID-19, and ultimately developing interventions to prevent or rehabilitate physical disability in these patients. This administrative supplement proposal is an extension of the existing K23 grant (5K23AG058756-01; “Sarcopenia as a Predictor of Hospital Associated Disability in Older Adults”), which was awarded to determine the ability of sarcopenia, operationalized as muscle mass and strength, to predict the development of activity of daily living (ADL) disability among hospitalized older adults. The additional studies proposed herein will leverage existing research infrastructure and experience to conduct an original prospective cohort study (COPE: COVID-19 Outcomes in Physical hEalth) that will compare short- and long-term functional outcomes of hospitalization for COVID-19 between older and younger adults and between those with and without AD/ADRD. These studies will also identify important pre-hospitalization risk factors (e.g. comorbidities and medication use) for adverse functional outcomes. We propose to enroll a cohort of 200 survivors of COVID-19 hospitalization (age 65 years and older, n=100, of whom n=25 with AD/ADRD; and age 64 years and younger, n=100) and to measure physical function outcomes (ADLs, frailty, mobility, sarcopenia, Health Assessment Questionnaire (HAQ), fatigue) by telephone interview at 1- and 3-months after hospital discharge. A subset of participants (n=50) will also undergo in-person assessments of body composition (DXA, ultrasound) and physical performance (muscle strength, Short Physical Performance Battery (SPPB)).

项目概要/摘要老年人中至少有一半的身体残疾是在急性住院期间出现的，并且患有阿尔茨海默病和阿尔茨海默病相关痴呆症 (AD/ADRD) 的患者尤其面临以下风险：因急性住院治疗等特定疾病而住院的老年人。肺炎和败血症，在 COVID-19 期间特别容易出现新的身体残疾。大流行期间，与年轻人相比，老年人患上更严重疾病的风险也更大 COVID-19，包括需要住院、需要入住 ICU 以及发生感染的更大风险截至 2020 年 5 月 6 日，全球已有超过 370 万人罹患肺炎和败血症。鉴于 COVID-19 大流行的历史规模，其中超过 258,000 人死亡。与 COVID-19 相关的身体残疾负担增加很可能对公共卫生产生巨大影响影响，特别是对老年人和 AD/ADRD 患者。然而，人们对其功能知之甚少。 COVID-19 的结果，尤其是老年人和患有 AD/ADRD 的人，他们最有可能解决这一关键的知识差距对于确定关键的临床风险因素至关重要。不良后果，有助于了解 COVID-19 后身体残疾的发病机制，以及最终制定干预措施来预防或康复这些患者的身体残疾。行政补充提案是现有 K23 拨款的延伸（5K23AG058756-01；“肌肉减少症作为老年人医院相关残疾的预测因子”），该奖项旨在确定肌肉减少症，可操作为肌肉质量和力量，以预测日常生活活动的发展本文提出的其他研究将利用现有的（ADL）残疾住院治疗。研究基础设施和经验进行原始前瞻性队列研究（COPE：COVID-19 身体健康结果）将比较住院治疗的短期和长期功能结果老年人和年轻人之间以及患有和不患有AD/ADRD 的人之间的COVID-19 这些研究。还将确定重要的住院前风险因素（例如合并症和药物使用），以防止不良反应我们建议招募 200 名 COVID-19 住院幸存者（65 岁）。岁及以上，n=100，其中 n=25 患有 AD/ADRD；年龄 64 岁及以下，n=100）并进行测量身体功能结果（ADL、虚弱、活动能力、肌肉减少症、健康评估问卷 (HAQ)、一部分参与者 (n=50) 将在出院后 1 个月和 3 个月通过电话访谈进行评估。还接受身体成分（DXA、超声波）和身体表现的现场评估（肌肉力量、短期体能测试（SPPB））。