老年肌少症（Sarcopenia）之診斷與檢測

The diagnosis and assessment of sarcopenia in the elderly

10.6634/JPSS-CCU.201612.24.08

張瀞文(Chang, Ching-Wen)；唐慧媛(Tang, Hui-Yua)；許哲豪(Syu, Jhe-Hao)

低肌肉量 ； 超高齡社會 ； 成功老化 ； low muscle mass ； super aged society ； successful aging

文化體育學刊

24輯（2017 / 03 / 01）

87 - 97

繁體中文

台灣人口快速老化，台灣正逐漸從「高齡化社會」邁向「高齡社會」，並在可預見的30年內轉變為「超高齡社會」。高齡化社會所伴隨而來的老年失能及老人照護問題早已成為全球性的議題，也是台灣社會即將面對的問題。在正常老化過程中所造成的老年肌少症近年來引發國際學界的關注，許多共識會議促使肌少症的定義與診斷逐漸明朗。本文彙整當前國外研究機構，歐洲老年肌少症事務委員會(EWGSOP)、亞洲肌少症共識會(AWGS)與日本肌少症專家學者，針對肌少症的篩檢所提出的診斷原則及檢測方法，在肌肉量判讀之截切點(cut off point)為肌肉質量低於18-40歲的年輕族群2個標準差；身體功能的篩檢法以步行速度測驗；肌力的篩檢法以握力測驗為其主要的檢測項目。肌少症嚴重者將喪失獨立生活的能力，但因人種的不同而有不同的截切點，藉此提供政府與民間組織作為建構肌少症篩檢機制之參考，亦藉此呼籲大眾重視老年人的肌少症問題，並以積極正面的態度朝向成功老化的目標邁進。

Taiwan is moving from ＂an aging society＂ to ＂an aged society＂ and expected to become ＂a super-aged society＂ in the next 30 years. The elderly disabled and elderly care in the aging societies are global issues and the problems facing Taiwan and many other countries.In recent years, sarcopenia of aging in a normal aging process is one of the topics that increasingly draw attentions in academia. This paper summarizes the diagnosis and assessment of sarcopenia of aging proposed by The European Working Group On Sarcopenia in Older People, The Asian Working Group for Sarcopenia , and Japan research institutions. The definition and Interpretation of sacorpenia use a cutoff point of 2 standard deviations below the muscle mass in young adults between the ages of 18 and 40 years. The screening method of body functions is by measuring the walking speed. The screening method of muscle strength is mainly by measuring the power of handgrip. Race will cause different cut off points. Severe sacorpenia will lose the ability to live independently. In addition, it calls for the general public to pay more attention to problem of the aging sarcopenia and furthermore take a positive attitude towards the goal of successful aging.

1. Baumgartner, R. N.,Koehler, K. M.,Gallagher, D.(1998).Epidemiology of sarcopenia among the elderly in New Mexico.American Journal of Epidemiol,147,755-763.
2. Chen, L. K.,Liu, L. K.,Woo, J.,Assantachai, P.,Auyeung, T. W.,Bahyah, K. S.,Arai, H.(2014).Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia.J Am Med Dir Assoc,15(2),95-101.
3. Collins-Hooper, H.,Woolley, T. E.,Dyson, L.,Patel, A.,Potter, P.,Baker, R. E.,Patel, K.(2012).Age-related changes in speed and mechanism of adult skeletal muscle stem cell migration.Stem Cells,30(6),1182-1195.
4. Cooper, C.,Dere, W.,Evans, W.(2012).Fraility and sarcopenia: definitions and outcome parameters.Osteoporos Int,23,1839-1848.
5. Cruz-Jentoft, A. J.,Baeyens, J. P.,Bauer, J. M.(2010).Sarcopenia: European consensus on definition and diagnosis: Report of the European Workong Group on Sarcopenia in Older People.Age and Ageing,39,412-423.
6. Cruz-Jentoft, A.,Landi, F.,Topinkova, E.,Michel, J. P.(2010).Understanding sarcopenia as a geriatric syndrome.Current Opinion in Clinical Nurtrition & Metabolic Care,13(1),1-7.
7. Demling, R. H.(2009).Nutrition, anabolism, and the wound healing process: an overview.Eplasty,9,e9.
8. Harman, M. J.,Fields, D. A.,Byrne, N. M.,Hunter, G. R.(2007).Resistance training improves metabolic economy durning functional tasks in older adults.J. Strength Cond Res.,21,91-95.
9. Janssen, I.,Heymsfield, S. B.,Ross, R.(2002).Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability.Journal of the American Geriatrics Society,50(5),889-896.
10. Jo, E.,Lee, S. R.,Park, B. S.,Kim, J. S.(2012).Potential mechanisms underlying the role of chronic inflammation in age-related muscle wasting.Aging Clinical and Experimental Research,24(5),412-422.
11. Kan, G. A. V.,Rolland, Y.,Andrieu, S.(2009).Gait speed at usual pace as a predictor of adverse outcome in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force.The Journal of Nutrition Health and Aging,13,881-889.
12. Landi, F.,Cruz-Jentoft, A. J.,Liperoti, R.,Russo, A.,Giovannini, S.,Tosato, M.,Onder, G.(2013).Sarcopenia and mortality risk in frail older persons aged 80 years and older: results from ilSIRENTE study.Age and Ageing,42(2),203-209.
13. McIntire, K. L.,Hoffman, A. R.(2011).The endocrine system and sarcopenia: potential therapeutic benefits.Current Aging Science,4(3),298-305.
14. Nagasaki, H.,Ito, H.,Furuna, T.(1995).The structure underlying physical performance measure for older adults in the community.Aging,7,451.
15. Rolland, Y.,Czerwinski, S.,Kan, G. A. V.(2008).Sarcopenia: its assessment, etiology, pathogenesis, consequence and furture perspectives.The Journal of Nutrition Health and Aging,12,433-450.
16. Roubenoff, R.,Hughes, V. A.(2000).Sarcopenia: current concepts.The journals of gerontology. Series A, Biological sciences and medical sciences,55(12),M716-724.
17. Shimada, H.,Kim, H.,Yoshida, H.(2010).Factors associated with timed "Up and Go" test score in elderly women.Therapy Science,22(3),273-278.
18. 行政院經濟建設委員會(2012)。中華民國2012 年至2060 年人口推計。台北市:經建會。
19. 吳易謙、熊昭、陳慶餘、吳名祥、許志成、台灣肌少症轉譯研究團隊成員(2014)。台灣社區老人肌少症流行病學初探。台灣醫學，18(3)，290-302。
20. 谷本芳美、渡美鈴、河野令(2010)。日本人筋肉量の加齡による特。日老医誌，47，52-57。
21. 周怡君、張皓詳、詹鼎正(2014)。肌少症的評估與預後。台灣醫學，18(3)，303-309。
22. 真田樹義、宮地元彥、山元健太、村上晴香(2010)。日本人成人男女を 象としたサルコペニア簡易評法の開。体力科學，59，291-302。
23. 張淑芳(2014)。老年肌少症之診斷與治療。護理雜誌，61(2)，101-105。
24. 鈴木隆雄(2011)。サルコペニアの基礎と臨床。東京:真興交易（株）醫書出版部。

1. 楊琇淳,陳芳婷,陳怡伶,林文豪,周世逢,田慧勳(2021)。跨領域團隊合作照護計畫對於肌少症前期之老年人的成效探討：前驅研究。醫學與健康期刊，10(1)，35-46。