数字健康老龄化路径:肌肉减少症与衰弱症整合训练
数字健康老龄化路径:肌少症-衰弱综合训练
研究概览
地位
详细说明
全球及区域人口老龄化进程正在加速,预期寿命与健康预期寿命之间的差距不断扩大,这主要归因于晚年身体功能和活动能力的下降(Guo等人,2022年)。 肌肉减少症和衰弱是主要的与年龄相关的公共卫生问题,它们导致功能能力下降、跌倒风险增加和死亡率上升(Lee等人,2022年;Petermann-Rocha等人,2021年)。 营养和体育活动综合干预被推荐为治疗肌肉减少症和衰弱的主要方法(Park & Lee,2023年)。 然而,目前的干预措施往往是通用的,导致干预不精确、不个性化,通常无法适应个体在基线力量和活动能力、营养状况、合并症、偏好和家庭环境方面的差异(Tighe等人,2020年)。 因此,干预措施个性化复杂,调整延迟,依从性不理想,削弱了现实世界的有效性。 未来的社区健康议程应优先考虑长期护理,消除获取障碍(如活动能力和交通),并从通用护理转向精准个性化。
世界卫生组织的健康老龄化十年和老年人综合护理(ICOPE)框架提供了一个实践锚点,通过以人为本的评估、个性化目标设定和持续随访来维持内在能力。 在这一范式中,肌肉减少症和衰弱管理通过协议驱动的关键路径(Sum等人,2022年)应用ICOPE——结构化决策支持将风险评估与定制处方和随访联系起来——可以在标准化质量的同时,实现在不同家庭环境中的精准个性化。
数字健康干预已扩展其能力,包括远程运动处方、微学习、提醒和远程指导,并有证据表明对体育活动、体能、身体成分和患者报告结果有益(De Santis等人,2023年)。 利用用户友好的数字工具简化功能评估并制定个性化健康计划是一种有前景的方法。
我们提出一种基于世界卫生组织ICOPE框架和协议驱动关键路径的数字平台支持干预,以识别社区居住老年人的护理需求。 该工具将允许医疗保健提供者准确评估个体需求,并在运动和营养方面定制干预措施,确保采取专注、有效的方法对抗老年人的肌肉减少症和衰弱。
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习联系方式
- 姓名:Doris Sau Fung YU, PhD
- 电话号码:852-3917-6319
- 邮箱:dyu1@hku.hk
学习地点
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Hong Kong、香港
- 招聘中
- The University of Hong Kong
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接触:
- Doris Sau Fung YU, PhD
- 电话号码:852-3917-6319
- 邮箱:dyu1@hku.hk
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参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
纳入标准:
- 年龄60岁或以上
- 假性肌少症——SARC-CaIF ≥ 11,优势手握力(男性<28公斤,女性<18公斤),椅子站立测试(5次)≥12秒,简易体能状况量表评分≤9;或根据相对四肢骨骼肌质量/身高诊断的肌少症(男性:<7公斤/平方米;女性:<5.4公斤/平方米);且为衰弱前期/衰弱状态——基于埃德蒙顿衰弱量表评分≥6
- 能够使用智能手机、电子平板或电脑
- 同意参与研究
排除标准:
- 存在与体力活动相悖的健康状况
- 正在参与其他持续的健康项目
学习计划
研究是如何设计的?
设计细节
- 主要用途:预防
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:单身的
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的:Volunteer-Engaged Lifestyle Optimisation via ICOPE for Sarcopenia program (VELO-S)
This digital program incorporates a 12-week, volunteer-engaged lifestyle optimisation programme grounded in WHO ICOPE and delivered through an ICOPE-based critical pathway for nutrition and exercise.
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A series of interactive lifestyle empowerment workshops will be conducted at community centres to translate the care plan into sustainable behavioural changes. One brief orientation and strategic planning and individualised care planning session, five volunteer-enhanced interactive workshops led by nurses will be delivered to equip older adults with knowledge and practical skills to manage sarcopenia. Participants will be assisted by a corresponding health coach throughout the 12-week intervention workshop. |
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有源比较器:Attention control
To control for the non-specific effects of receiving attention and social interaction on outcomes, participants in the attention control group will receive an education protocol that is unrelated to sarcoepnia, with comparable duration and frequency of contact and engagement to those in the intervention group ensuring comparable exposure to social engagement and attention.
Educational materials will be distributed to participants.
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The attention control group receives six session meeting covering topics unrelated to sarcopenia, it will be delivered in a small-group with comparable duration and frequency of contact and engagement to those in the intervention group
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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四肢骨骼肌质量指数(ASMI)
大体时间:基线(T0)、3个月(T1)和6个月(T2)
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通过生物电阻抗分析(BIA)测量的四肢骨骼肌质量指数(ASMI)
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基线(T0)、3个月(T1)和6个月(T2)
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握力
大体时间:基线(T0)、3个月(T1)和6个月(T2)
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握力将通过液压握力计测量优势手,取3次测量中的最高值。
低肌肉力量定义为男性<28kg,女性<18kg。
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基线(T0)、3个月(T1)和6个月(T2)
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简短体能表现测试(SPPB)
大体时间:基线(T0)、3个月(T1)和3个月(T2)
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身体功能将通过短期体能表现测试(SPPB)进行评估,该测试综合了平衡测试、步态速度和椅子站立测试。
SPPB评分范围为0-12分,分数越高表示身体表现越好。
低身体功能定义为SPPB评分≤9分。
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基线(T0)、3个月(T1)和3个月(T2)
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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肌肉减少症和小腿围量表 (SARC-CalF)
大体时间:基线(T0)、3个月(T1)和6个月(T2)
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肌肉减少症和小腿围量表(SARC-CalF)包括5个项目(力量、行走辅助、从椅子上站起、爬楼梯、跌倒、小腿围)。
评分范围为0至20分,得分≥11分提示可能存在肌肉减少症。
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基线(T0)、3个月(T1)和6个月(T2)
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计时起立行走测试
大体时间:基线(T0)、3个月(T1)和6个月(T2)
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通过计时起立行走测试测量,单位为秒。
完成时间越短,表明移动能力和平衡能力越好。
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基线(T0)、3个月(T1)和6个月(T2)
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微型营养评估(MNA)
大体时间:基线(T0)、3个月(T1)和6个月(T2)
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通过微型营养评估进行测量(评分范围为0到30),评分越低表明营养不良风险越高。
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基线(T0)、3个月(T1)和6个月(T2)
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11项埃德蒙顿衰弱量表
大体时间:基线(T0)、3个月(T1)和6个月(T2)
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埃德蒙顿衰弱量表(EFS)的评分范围为0至17分,分数越高表示衰弱程度越严重。
通常将EFS评分≥8分用作衰弱的临界值。
评分6-7分标识患者处于风险状态。
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基线(T0)、3个月(T1)和6个月(T2)
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国际体力活动问卷(IPAQ-短版)
大体时间:基线 (T0)、3个月 (T1) 和 6个月 (T2)
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通过国际体力活动问卷测量,这是一种自我报告的体力活动评估方法。
将报告步行、中等强度和剧烈体力活动的频率及持续时间。
体力活动时间越长,表明体力活动水平越高。
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基线 (T0)、3个月 (T1) 和 6个月 (T2)
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The EuroQoL-5D-5L instruments
大体时间:Baseline (T0), 3 months (T1), and 6 months (T2)
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Assess the health-related quality of life to generate the utility score for cost-effective analysis.
Including the status on mobility, self-care, usual activities, pain/discomfort, and anxiety/depression using a 5-level response set, with "unable to" levels mean a worse situation.
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Baseline (T0), 3 months (T1), and 6 months (T2)
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The EuroQoL-5D-5L Visual Analog Scale
大体时间:Baseline (T0), 3 months (T1), and 6 months (T2)
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Assess the health-related quality of lifeby a 0-100 scores Visual Analog Scale to measure perceived health, higher scores mean a better outcome.
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Baseline (T0), 3 months (T1), and 6 months (T2)
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Lipid Biomarkers
大体时间:Baseline (T0)
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Assess the comprehensive lipid panel including triglyceride, total cholesterol, high-density lipoprotein and low density lipoprotein through capillary blood samples collected via fingertip puncture
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Baseline (T0)
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Metabolic Biomarkers
大体时间:Baseline (T0)
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Assess the fasting glucose through capillary blood samples collected via fingertip puncture
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Baseline (T0)
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合作者和调查者
调查人员
- 首席研究员:Doris Sau Fung YU, PhD、The University of Hong Kong
出版物和有用的链接
一般刊物
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研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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