老年新型肥胖：肌少性肥胖之評析

New Phenotype of Obesity in Elderly People: Comments of Sarcopenic Obesity

1993 年臺灣已正式步入高齡化社會，直到2010 年65 歲以上老年人口比例為10.7%，預計在2026 年老年人口比例將達到20%步入超高齡社會。近年來老人照護重要議題－「肌少性肥胖」逐漸被加以重視。研究指出，60 歲以上長者其肌少性肥胖之盛行率達7.4-12.4%，且女性較男性傾向有較高的盛行率。學者建議肌少性肥胖測量要考慮肌肉和脂肪分佈，男性測量以四肢骨骼肌肉質量除以身高平方為主，女性採四肢骨骼肌肉質量除以體重，以作為判定肌少性肥胖方法。運動與飲食控制是防治肌少性肥胖重要的方向。研究指出，飲食加上運動能增加瘦肉組織和髖骨骨密度，同時能改善肌力、平衡和行走速度。有鑑於肌少性肥胖的定義尚未有共識，目前多數學者同意肌少性肥胖會受到年齡、族群及性別的影響，並建議除了評估肥胖和肌肉質量之外，更要重視其可能造成的不良後果，如功能限制和死亡的風險。因此，瞭解長者老化過程的發展，尋找適合的篩檢指標或診斷切點，積極研發改善高齡長者肌少性肥胖之周全性照護，將是未來護理專業人員須要致力研究及發展重要議題。

In 1993, Taiwan officially became an aging society. By 2010, the number of elderly people aged 65 years or older accounted for 10.7% of the population in Taiwan. This number is predicted to account for 20% of the population in Taiwan by 2026, rendering the Taiwanese society a super aging society. In recent years, a crucial concern in geriatric care- sarcopenic obesity- has gradually received attention. Previous studies have indicated that the prevalence of sarcopenic obesity in elderly people reached 7.4%–12.4%; this trend was observed particularly among women. Researchers have suggested that muscle and fat distributions be considered in sarcopenic obesity measurement. Sarcopenic obesity is mainly measured by dividing skeletal muscle mass by height squared for men and by dividing skeletal muscle mass by weight for women. Exercise and dietary control are crucial methods used to prevent sarcopenic obesity. Previous studies have reported that dietary control combined with exercise can increase lean tissue mass and hip bone mineral density as well as improve muscle strength, balance, and walking speed. Although no consensus has been attained on the definition of sarcopenic obesity, most researchers have agreed that sarcopenic obesity is related to age, ethnicity, and sex and that, in addition to assessing obesity symptoms and muscle mass, attention must be paid to possible adverse outcomes caused by sarcopenic obesity (e.g., functional limitation and the risk of mortality). Therefore, understanding the aging process of elderly people, identifying appropriate screening indices and diagnosis criteria, and actively developing methods through which comprehensive care for elderly people with sarcopenic obesity can be improved are crucial objectives that health care professionals must endeavor to achieve.