フレイルティ＆サルコペニアと ... - f.kpu-m.ac.jp

1 535 2 4 9 2 1 6 02 0857 121 1 0 5 35 5 47 2 012 SPD Frailty,Sarcopenia,andLong-termCarePreve ntionYosukeYamada ,EmiYamagata andMisakaKimura GraduateSchoolofNursingandHealthCareScie nce,MasterofNursingforHealthCareScience, KyotoPrefecturalUniversityofMedicineLabo ntoryofAppliedHealthSceince,Departmentof Nursing,KyotoprefecturalofMedicine ReseachFellow,JapanSocitetyforthePromoti onofScience GraduateSchoolofNursingandHealthCareScie nce,MasterofNursingforHealthCareScience, KyotoPrefecturalUniversityofMedicineDepa rtmentofNursing,GerontologicalNursing,Ky otoprefecturalUniversityofMedicine 80 frailty frailty sarcopenia frailty sarcopenia Frailty Sarcopenia AbstractAselderlypeoplegetolder,theirmen talandphysicalfunctionsgraduallydecline, thelevelsofactivityandindependenceindail ylivingdecrease,andnursingcarebecomesnec essary.

2 Debilitation isafrequentcauseoflong-termcareneedintho seagedover80years, ,thisis 1 frailty frailty disability geriatricsyndrome disability 1980 1978 FederalCouncilonAging 75 adversehealthoutcomes vulnerability subclinical frailty comorbidity frailty disability 1 frailty disability disability 75 90

3 Frailty disability Fried FrailtyWorkingGroup frailty disability Fried frailty nofrailty frailty disability 2 physicalfrailty psychologicalproblems socialproblems frailty physicalfrailty Freid theCardiovascularHealthStudy CHS 1 2 3 4 5 5 3 frailty 1 CHSindex 65 7 80 30 frailty CHSindex Ensrud theStudyofOsteoporoticFracture SOF 1 2 3 3 2 536 consideredtobeastatebasedon frailty , :Frailty,Sarcopenia,Long-termcareprevent ion.

4 537 1 2 A B @@@@@@@@ @@ @@ @@@ @@ @@ @ 1 CHSindex * frailty 2 SOFindex 3 CHSindex SOFindex 1 sarcopenia sarcopenia RosenbergIH sarco flesh penia loss 20 70 25 30 30 40 50 1 2 typeIIa dynapenia sarcopenia 2010 4 13 AgeandAging EuropeanUnionGeriatricMedicineSociety EWGSOP 538 2 SOFindex 3 @@ activitiesofdailylife,ADL EWGSOP sarcopenia 4 presarcopenia sarcopenia 3 severesarcopenia 5 2 1 1960 Allen EWGSOP magneticresonanceimaging:MRI computedtomography:CT 2 X energyX-rayabsorptiometry:DXA bioimpedanceanalysis.

5 BIA BIA 539 4 EWGSOP* 5 EWGSOP* @@@@ 12 BIA 2 3 MRI CT DXA CT MRI ECW ECW S-BIS MRI CT 4 2 DXA kg m skeletalmuscleindex SMI kg/m2 Baumgartner 2 SMI SMI 40 266 263 DXA SMI Baumgartner SMI BIA SMI Janssen BIA sarcopenia 540 2 Yamadaetal.

6 22 sarcopenia 31cm ) 541 3 23 20 BI 4 Yamadaetal 28 mean SD ** P P SMI BMI BMI 3 400 300 650 50 ADL EWGSOP

7 30kg 20kg 4 EWGSOP frailty EWGSOP TimedUP&GOTest 3m 11 5 EWGSOP 5 1 542 6 Fried frailtycycle.

8 543 5 17-18 6 XueQL, 63 984-90 2 1 E D 3 30 40 2 frailty disability 7 sarcopenia frailty disability

9 544 7 sarcopenia 6 frailtycycle 1 Sarcopenia&Frailty 2009;46 2011;119 2011;119 FriedLP,FerrucciL,DarerJ,WilliamsonJD, ,frailty, ;59 FerrucciL,GuralnikJM,StudenskiS,FriedLP, CutlerGBJr, ,controlledtrialsaimedatpreventingordela yingfunctionaldecline and disability in frail, ;52 Bandeen-RocheK,XueQL,FerrucciL,WalstonJ, GuralnikJM,ChavesP,ZegerSL, :characterizationinthewomen' ;61 FriedLP,TangenCM,WalstonJ,NewmanAB,Hirsc hC,GottdienerJ,SeemanT,TracyR,KopWJ,Burk eG, ;56 EnsrudKE,EwingSK,TaylorBC,FinkHA,Cawthon PM,StoneKL,HillierTA,CauleyJA,HochbergMC ,RodondiN,TracyJK, ,disability,fractures, ;168 Rosenberg :originsand ;127 :causes,consequences, ;58 Iannuzzi-SucichM,PrestwoodKM, , ;57 RoubenoffR,RallLC,VeldhuisJD,KehayiasJJ, RosenC,NicolsonM,LundgrenN, ;83 FaulknerJA,LarkinLM,ClaflinDR, ;34 LexellJ,TaylorCC,Sj str ageing atrophy?

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