Longitudinalna raziskava gibalne dejavnosti in pojavnosti sarkopenije pri starostnikih : doktorska disertacija

Teraž, Kaja (author), PIŠOT, RADO (mentor), Pori, Primož (comentor)

Sarkopenija je pojav upada mišične jakosti in mišične mase ter hkrati slabenja telesnih zmogljivosti. O sarkopeniji govorimo, ko pri posamezniku pride do upada mišične jakosti, ki je lahko posledica manjše količine mišične mase. Dodatno slabša telesna zmogljivost določa stopnjo sarkopenije. Na sarkopenijo vplivajo številni dejavniki, ki jih v grobem delimo na biološke in vedenjske. Med pomembnejše vedenjske dejavnike spadata gibalna dejavnost in prehranjevalne navade. Namen doktorske disertacije je preučiti gibalne in prehranske dejavnike v povezavi s sarkopeničnimi značilnostmi pri aktivnih starostnikih v daljšem časovnem obdobju. Predvidevali smo, da se bodo v osmih letih pojavile spremembe, individualno prilagojene glede na življenjski slog, v sarkopeničnih značilnostih preiskovancev. Natančneje, da bodo starostniki, ki so poročali o pogostejši in intenzivnejši gibalni dejavnosti ter krajšem času, ki so ga presedeli, dosegli boljše rezultate na sarkopeničnih testih v primerjavi s starostniki, ki so manj aktivni in več časa presedijo. Predvideli smo tudi, da bodo starostniki, ki so se v mladosti ukvarjali s tekmovalnim športom, imeli boljše rezultate na sarkopeničnih testih kot starostniki, ki se v preteklosti niso ukvarjali s tekmovalnim športom. Zaključki obravnavanih predhodnih raziskav nakazujejo na pozitiven vpliv gibalnih in prehranskih intervencij na obvladovanje sarkopenije. Med letoma 2012 in 2013 so bile v sklopu množičnih meritev mednarodnega projekta Gibalna aktivnost in prehrana za kakovostno staranje, ang. Physical activity and nutrition for great ageing oziroma PANGeA, opravljene meritve na vzorcu aktivnih starostnikov (n = 147) iz Kopra in okolice. V sklopu projekta so analizirali tudi gibalne in prehranjevalne navade vključenih preiskovancev. V izbrani bateriji spremenljivk so bile med drugim tudi antropometrične meritve, test hitrosti hoje, test stiska pesti ter izbrani vprašalnik s sociodemografskimi vprašanji in vprašanji o gibalnih navadah. Leta 2021 smo isti vzorec preiskovancev najprej pisno povabili na ponovne meritve ter jih nato dodatno pozvali še s telefonskim pogovorom. Izbranim preiskovancem smo podrobneje predstavili sarkopenične značilnosti, sociodemografske značilnosti in gibalne ter prehranske navade. Pridobljeno stanje prvih meritev iz leta 2013 je služilo za umeščanje naknadno izmerjenega vzorca v longitudinalen okvir raziskave. Na druge meritve v letu 2021 se je odzvalo 52 oseb (35 % prvotnega vzorca), in sicer smo poleg izbranih spremenljivk iz leta 2013 opravili še dodatne teste za klasificiranje sarkopeničnih značilnosti ter gibalno dejavnost in sedentarno vedenje ocenili z objektivno metodo, s pospeškometri. Prav tako smo s preiskovanci opravili intervju za analizo sociodemografskega statusa, ki je vključeval tudi njihove gibalne in prehranske navade ter značilno soočanje z zaprtjem države med epidemijo COVID-19. Osem let od prvih meritev smo ugotovili pojavnost sarkopenije pri 13,5 % preiskovancev, zabeležili smo 10,2-odstotni upad mišične jakosti ter 5,4-odstotni upad mišične mase pri sodelujočih. Kljub vsemu pa nismo našli sprememb v sarkopeničih značilnostih, ki bi bile značilne za opisani življenjski slog. Nadalje, naši preiskovanci so bili pri večini testov, merjenih na drugih meritvah, uspešnejši od povprečno gibalno dejavnih starostnikov, o katerih so poročali v literaturi. Zaznali smo tudi povezanost prehranjenosti posameznika z izbranimi sarkopeničnimi značnostmi; posamezniki z višjim rezultatom na testu mini prehranske anamneze (MNA) so imeli boljše rezultate na testu vstajanja s stola (r = –0,441; p = 0,006), hitrejšo hojo (r = 0,352; p = 0,030), hitreje so opravili test TUG (r = 0,454; p = 0,004) ter dosegli višje število točk na kratki testni bateriji gibalne učinkovitosti ali KBGU (r = 0,379; p = 0,019). Ko smo ugotavljali razlike v sarkopeničnih značilnostih med starostniki, ki so se v mladosti ukvarjali s športom in tistimi, ki se niso, nismo našli razlik. Novejša literatura sicer nakazuje na pozitiven vpliv ukvarjanja s športom v mladosti na zdravstveno stanje starostnikov, vendar naša raziskava tega ni potrdila. . Nekateri naši rezultati in literatura nakazujejo, da ima lahko dolgotrajen aktiven življenjski slog starostnikov pozitivne učinke na sarkopenične značilnosti ter na druge vidike staranja kot so zadovoljstvo in splošno kakovost življenja v tretjem življenjskem obdobju, vendar je potrebno za oblikovanje takih zaključkov odgovoriti še na nekatera raziskovalna vprašanja, ki so preverjena na večjem številu daljših longitudinalnih raziskav.

• Language: Slovenian
• Keywords: Skeletnomišična motnja / gibanje / sedenje / starejši odrasli / aktivno staranje
• Work type: Doctoral dissertation
• Typology: 2.08 - Doctoral Dissertation
• Organization: FŠ - Faculty of Sport
• Year: 2024
• PID: 20.500.12556/RUL-159590
• COBISS.SI-ID: 202036995
• Publication date in RUL: 13.07.2024

Secondary language

• Language: English
• Title: Longitudinal study of physical activity and incidence of sarcopenia among older people

Abstract

Sarcopenia is a decline in muscle strength and muscle mass associated with a decrease in physical performance. Sarcopenia is when a person experiences a decline in muscle strength as a result of decreased muscle mass. The resulting decrease in physical performance determines the degree of sarcopenia. Sarcopenia is influenced by several factors, which can be broadly divided into biological and behavioural factors. The most important behavioural factors include physical activity and dietary habits. This dissertation aims to investigate physical activity and dietary factors in relation to sarcopenia parameters in active older adults over time. We hypothesised that sarcopenia parameters, individually adjusted for lifestyle, would change over 8 years. Specifically, older adults who engaged in more frequent and intense physical activity and spent less time sitting should perform better on sarcopenia tests than older adults who were less active and spent more time sitting. We also predicted that older adults who were engaged in sports in their youth would do better on sarcopenia tests than older adults who did not play competitive sports in the past. The conclusions of the previous studies suggest a positive impact of exercise and nutritional interventions have a positive effect on the treatment of sarcopenia. Between 2012 and 2013, a sample of active older adults (n = 147) from Koper and its surroundings was studied as part of the international project Physical Activity and Nutrition for Great Ageing (PANGeA). The project also analysed the physical activity and dietary habits of the subjects. The selected battery of variables included anthropometric measurements, a gait speed test, a handgrip strength, and a selected sociodemographic questionnaire and exercise habits. In 2021, the same sample of participants was invited for a second measurements. The first invitation was sent in writing and then additionally by telephone. The selected subjects were interviewed in more detail about sarcopenia parameters, sociodemographic characteristics, and exercise and dietary habits. The status obtained from the initial measurements in 2013 was used to place the subsequently measured sample into the longitudinal context of the study. Fifty-two subjects (35 % of the primary sample) participated in the second measurement in 2021, in which, in addition to the variables selected in 2013, we performed additional tests to classify sarcopenia parameters and assessed physical activity and sedentary behaviour using an objective method, the accelerometer. We also interviewed subjects to analyse their sociodemographic status, including their exercise and dietary habits and their typical coping with the closure of the country during the COVID-19 epidemic. Eight years after the initial measurements, we detected sarcopenia in 13.5 % of participants, a 10.2 % annual decrease in muscle strength, and a 5.4 % muscle mass in participants. However, we did not find any changes in sarcopenia parameters that were individually adjusted for described lifestyle. Furthermore, our participants outperformed the results of the average physically active older adult reported in the literature. We observed an association of individual nutritional status with selected sarcopenia parameters; as individuals with higher scores on the Mini Nutritional Assessment (MNA) test had better results on the Chair stand test (r = -0.441; p = 0.006), gait speed (r = 0.352; p = 0.030), performed faster on the TUG test (r = 0.454; p = 0.004) and scored better on the Short Physical Performance Test (SPPB) (r = 0.379; p = 0.019). When we looked for differences in sarcopenia parameters between older adults who had participated in sports in their youth and those who did not, we found no differences. Although recent literature suggests a positive effect of engaging in sports in youth on health status in old age, our study did not confirm that. Some of our results and the literature suggest that a prolonged active lifestyle in the elderly may have positive effects on sarcopenic characteristics and on other aspects of ageing such as satisfaction and overall quality of life in the third stage of life, but additional research needs to be done to draw such conclusions.

• Keywords: Skeletal muscle disorder / exercise / sedentarism / older adults / active ageing