The Status Of Sarcopenia And Its Impact On Quality Of Life In Middle-aged And Elderly Patients With Knee Osteoarthritis

Objective: To investigate the current situation of sarcopenia in middle-aged and elderly patients with knee osteoarthritis(KOA),analyze the influencing factors for sarcopenia in patients with KOA,and explore the effect of sarcopenia on the quality of life of patients with KOA,so as to provide theoretical basis for nursing workers to formulate scientific and reasonable prevention and intervention measures for sarcopenia in KOA patients.Methods: This study was a cross-sectional survey study.A convenience sampling method was used to select 202 patients over 50 years old with knee osteoarthritis who were admitted to the Department of Joint Surgery,a tertiary general hospital in Guizhou Province from July2019 to November 2020.The WOMAC scale,the concise health status scale(SF-36)and the general information questionnaire designed by the researcher were used to investigate the general demographic data,knee function level and general quality of life of middle-aged and elderly patients with KOA;Bioelectrical Impedance Analysis(BIA)was used to measure the body composition indexes such as limbs skeletal muscle mass,body fat percentage and visceral fat area of patient’s;The muscle strength of the patients was evaluated by hand grip strength measurement,and the body indexes such as waist circumference,hip circumference and calf circumference were measured at the same time.According to the diagnostic criteria of sarcopenia in the Asian sarcopenia Working Group(AWGS 2019),the subjects were divided into sarcopenia group and non-sarcopenia group.Logistic regression analysis was used to analyze the related factors that may affect the occurrence of sarcopenia in KOA patients,so as to explore the independent influencing factors of sarcopenia in KOA patients.Spearman correlation analysis and hierarchical regression analysis were used to explore the effect of sarcopenia on the quality of life of KOA patients.Results:1.There were 48 males(23.8 %)and 154 females(76.2 %)in 202 middle-aged and elderly KOA patients,The average age was 66.51±6.95 years.The detection rate of sarcopenia was19.3 %,and the detection rate of sarcopenia obesity was 10.9 %.The detection rate of low muscle mass was 22.8 %,and the detection rate of low muscle strength was 51.5 %.There was no significant difference in the detection rate between men and women in each group(P > 0.05).2.Compared with the non-sarcopenia group,there were statistically significant differences in exercise,fall history,KL grade,body weight,BMI,grip strength,ASM,SMI,waist circumference,waist-hip ratio,visceral fat area,body fat percentage,bone mineral content and Calf circumference between the two groups(P < 0.05).3.Multiple Logistic regression analysis showed that disease duration,exercise < 3 times per week,body fat percentage and visceral fat area were risk factors for sarcopenia(P < 0.05),while BMI was a protective factor for sarcopenia(P < 0.05).4.SF-36 scale was used to evaluate the quality of life of middle-aged and elderly patients with KOA.Compared with the domestic norm,the score of quality of life of the subjects in this study was lower,and the total score of physical health was 40.05 ± The total score of mental health was 67.63 ± The score of physical function was the lowest,and the score of mental health was the highest.5.Spearman correlation analysis demonstrated that grip strength and skeletal muscle mass of limbs were significantly positively correlated with quality of life(PCS and MAC)(P <0.05).Except for the mental health dimension,the scores of other dimensions of the quality of life of KOA patients with sarcopenia were significantly lower than those of KOA patients without sarcopenia(P<0.05).6.The results of stratified regression analysis revealed that sarcopenia was an important influencing factor of quality of life in middle-aged and elderly patients with KOA(P < 0.05).Combined with KL grade and WOMAC score,it showed 67.0% of the total variation of physical health dimension of quality of life,and it demonstrated 34.7% of the total variation of mental health dimension of quality of life combined with disease course and WOMAC score.Conclusion:1.In this study,the detection rate of sarcopenia in middle-aged and elderly patients with KOA was slightly higher than that in other regional reports in China,and most patients had decreased muscle strength.Long duration of disease,lack of exercise,increased body fat percentage and visceral fat area were independent risk factors for sarcopenia in KOA patients,while increased BMI was a protective factor for sarcopenia.2.The quality of life of middle-aged and elderly KOA patients with sarcopenia is poor,and sarcopenia has a negative predictive effect on the physiological and mental health of KOA patients.