老年人肌少症之臨床照護指引

肌少症（sarcopenia）是老人醫學科普遍的症候群，但它卻不常被診斷出，且因為它不易造成急性生理損傷，所以易被忽視而錯失早期診斷及預防。此外，由於肌少症與老人衰弱症息息相關，更值得被關注及重視。本文旨在描述「老年肌少症之臨床照護指引」發展過程，透過組成相關小組、實證文獻的查證、評析並從中篩選出適用文獻共36篇，其中包含：實驗性研究11篇，觀察分析研究4篇，觀察描述研究9篇和專家意見之文獻回顧12篇，並依據Joanna Briggs Institute建議之文獻證據等級評析標準，進行實證文獻回顧之綜合整理，再經由臨床專家效度問卷調查及建議，最後評析發展出照護指引。臨床照護指引內容範圍包含：指引的範圍界定、肌少症的評估／篩檢方式，肌少症之處置建議等。透過臨床照護指引冀望提供臨床第一線專科護理師，早期診斷及具實證的照護策略建議，藉此預防肌少症，降低跌倒的風險和失能的發生。

關鍵字

肌少症；高齡者；照護指引；實證

並列摘要

Sarcopenia is a common syndrome in geriatric medicine, but it is not commonly diagnosed. In addition, it can be easily overlooked because it is not associated with acute physiological damage, which could prevent from early diagnosis and prevention. Moreover, as sarcopenia is closely related to geriatric frailty, it deserves particular attention and consideration. This article describes the development of the ＂Guidelines for Clinical Care of Sarcopenia in Older Adults＂, including the establishment of a task force and review of evidence-based literature. A total of 36 relevant studies were identified, including 11 experimental studies, four analytical observational studies, nine descriptive observational studies, and 12 expert reviews. These studies were comprehensively reviewed based on the levels of evidence hierarchy developed by the Joanna Briggs Institute, followed by a content validity evaluation by a group of clinical experts to finalize the present guidelines. The clinical guidelines include: the scope of the guidelines, assessment and screening methods of sarcopenia, and recommendations for the management of sarcopenia. It is hoped that the present clinical guidelines can provide front-line nurse practitioners recommendations for early diagnosis and evidence-based treatment strategies, and to prevent sarcopenia and reduce the risk of falls and subsequent disability.

並列關鍵字

sarcopenia ； older adults ； clinical practice guidelines ； evidence-based

參考文獻

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研究成員（2014）．台灣社區老人肌少症流行病學初探．臺灣醫學，18（3），290－302。https://doi.org/10.6320/FJM.2014.18(3).04

Beaudart, C., Dawson, A., Shaw, S. C., Harvey, N. C., Kanis, J. A., Binkley, N., Reginster, J. Y., Chapurlat, R., Chan, D. C., Bruyère, O., Rizzoli, R., Cooper, C., Dennison, E. M., & IOF-ESCEO Sarcopenia Working Group (2017). Nutrition and physical activity in the prevention and treatment of sarcopenia: systematic review. Osteoporosis international, 28(6), 1817-1833. https://doi.org/10.1007/s00198-017-3980-9

Bosaeus, I., & Rothenberg, E. (2016). Nutrition and physical activity for the prevention and treatment of age-related sarcopenia. Proceedings of the Nutrition Society, 75(2), 174-180. https://doi.org/10.1017/S002966511500422X

Bruyère, O., Cavalier, E., Buckinx, F., & Reginster, J. Y. (2017). Relevance of vitamin D in the pathogenesis and therapy of frailty. Current Opinion in Clinical Nutrition and Metabolic Care, 20(1), 26-29. https://doi.org/10.1097/MCO.0000000000000334

Buchmann, N., Nikolov, J., Spira, D., Demuth, I., Steinhagen-Thiessen, E., Eckardt, R., & Norman, K. (2016). Identifying sarcopenia in metabolic syndrome: data from the Berlin Aging Study II. Journal of Gerontology. Series A: Biological Sciences and Medical Sciences, 71(2), 265-272. https://doi.org/10.1093/gerona/glv089

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老年人肌少症之臨床照護指引

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