Clinical Significance of Short-term Change and Variability of Grip Strength

握力短期变化和变异的临床意义

• 批准号: 8451339
• 负责人: Qian-Li Xue
• 金额: $ 7.65万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8451339
• 关键词: Address; Aging; Area; Biological Markers; Blood Pressure; Blood Vessels; Clinical; Clinical Trials; Data; Data Quality; Diagnosis; Distal; Elderly; Endocrine; Epidemiology; Event; Family; Future; Gait; Goals; Hand; Health; Health Status; Heterogeneity; Homeostasis; Hormones; Intervention; Intervention Studies; Knowledge; Link; Measurement; Measures; Muscle Weakness; Outcome; Patients; Performance; Persons; Phenotype; Physical Function; Physiological; Process; Relative (related person); Reporting; Risk; Risk Assessment; Risk Factors; Sampling; Sampling Studies; Skeletal Muscle; Speed; Statistical Methods; Statistical Models; Target Populations; Testing; Time; Visit; Woman; Women' s Health; Work; adverse outcome; age related; aged; base; biological systems; clinically relevant; clinically significant; design; disability; follow-up; frailty; grasp; improved; interest; middle age; mortality; muscle form; muscle strength; older women; pilot trial; prevent; prognostic; sarcopenia; stressor; success

DESCRIPTION (provided by applicant): Aging is associated with progressive lose of skeletal muscle mass and strength referred to as sarcopenia, a significant risk factor for disability, fraily, and mortality. Epidemiologically, muscle weakness defined based on a single measurement of hand grip strength has repeatedly proven to correlate with subsequent adverse health outcomes, even when measured in mid-life to predict physical disability decades later. These findings have led to ongoing efforts to define clinically meaningful cut points for muscle strength in the diagnosis of sarcopenia and growing interest in using grip strength as a key endpoint in clinical trials of new interventions for frailty. However, the success of such efforts requires improved knowledge in two areas. First, whether a single measurement of strength can sufficiently capture the underlying risk? Second, given that most of the pilot trials have a short follow-up, typically 6 months; it is important to know the degree and heterogeneity of detectable change in the short term and the clinical relevance of such change to long-term health outcomes. So far, these topics have not been adequately studied in a longitudinal setting. The central hypothesis is that short term trajectory of grip strength, characterized by rate of change and intra-person variability in grip strength, predicts long term trajectory of grip strength and adverse health outcomes in older adults. To test this hypothesis, this project proposes to evaluate: (i) the heterogeneity of short-term (6-month) trajectory of grip strength, (ii) the impac of short-term trajectory of grip strength on long-term (3- year) trajectories of health outcomes, and (iii) the effect of multisystem physiological dysregulation on short-term trajectory of grip strength. The study applies state-of-the-art statistical models to analyze existing longitudinal data from the Weekly Disability Substudy of the Women's Health and Aging Study (WHAS ) I. The substudy is comprised of 102 women aged 65 years and over who were evaluated on a weekly basis over six months, followed by additional five semi-annual visits of 6 months apart for a total follow-up of three years between 1993 and 1996.

描述（由申请人提供）：衰老与骨骼肌质量的逐渐丧失有关，并称为肌肉减少症，这是残疾，周年和死亡率的重要危险因素。从流行病学上讲，基于手柄强度的单个测量的肌肉无力已被证明与随后的不良健康结果相关，即使在中期进行了测量以预测数十年后的身体残疾。这些发现导致持续的努力定义了临床上有意义的肌肉力量的切点 在诊断肌肉减少症和对使用握把强度作为新干预措施的临床试验中的关键终点的兴趣越来越大。但是，这种努力的成功需要在两个领域的知识中提高知识。首先，单一的强度测量是否可以充分捕获潜在的风险？其次，鉴于大多数试验试验的随访时间很短，通常为6个月。重要的是要了解短期内可检测变化的程度和异质性，以及这种变化与长期健康结果的临床相关性。到目前为止，这些主题尚未在纵向环境中进行充分研究。中心假设是，抓地力强度的短期轨迹，其特征是抓地力强度的变化率和人体内变异性，可预测老年人抓地力强度和不良健康结果的长期轨迹。为了检验这一假设，该项目提议评估：（i）短期（6个月）抓地力的轨迹的异质性，（ii）抓地力强度的短期轨迹对健康成果的长期（3年）轨迹的影响，以及（iii）（iii）对短期生理学型培养的多疾病的影响。该研究应用最先进的统计模型来分析妇女健康和衰老研究（WHAS）的每周残疾的现有纵向数据I。该子女由102名65岁及65岁以上的妇女组成，这些妇女每周在六个月内每周进行一次评估，在六个月中，在6个月内进行了6个半年度的访问，随后进行了6个半年度的访问，以进行6年的额外跟进，以进行三个月的跟进，以供三个月的时间持续时间，为期三年的时间，这是三个月的时间。