文章摘要
樊俊宁,杨淞淳,孙至佳,汪涵,马圆,王波,余灿清,宁毅,吕筠,李立明.北京美兆体检人群的衰弱状态变化及衰弱恶化的影响因素分析[J].中华流行病学杂志,2021,42(8):1453-1459
北京美兆体检人群的衰弱状态变化及衰弱恶化的影响因素分析
Transitions on frailty status and related risk factors for its status worsening: finding from the Beijing MJ Health Screening Center
收稿日期:2020-12-17  出版日期:2021-08-19
DOI:10.3760/cma.j.cn112338-20201217-01416
中文关键词: 衰弱指数;衰弱变化;影响因素;体检人群
英文关键词: Frailty index;Frailty transition;Risk factor;Health checkup
基金项目:国家自然科学基金(91846303,81941018)
作者单位E-mail
樊俊宁 北京大学公共卫生学院流行病与卫生统计学系 100191  
杨淞淳 北京大学公共卫生学院流行病与卫生统计学系 100191  
孙至佳 北京大学公共卫生学院流行病与卫生统计学系 100191  
汪涵 北京大学公共卫生学院流行病与卫生统计学系 100191  
马圆 美年健康产业研究院 100191  
王波 美年健康产业研究院 100191
北京大学医学部美年公众健康研究院 100191 
 
余灿清 北京大学公共卫生学院流行病与卫生统计学系 100191
北京大学医学部美年公众健康研究院 100191
北京大学公众健康与重大疫情防控战略研究中心 100191 
 
宁毅 美年健康产业研究院 100191
北京大学医学部美年公众健康研究院 100191 
yi.ning@meinianresearch.com 
吕筠 北京大学公共卫生学院流行病与卫生统计学系 100191
北京大学医学部美年公众健康研究院 100191
北京大学公众健康与重大疫情防控战略研究中心 100191 
lvjun@bjmu.edu.cn 
李立明 北京大学公共卫生学院流行病与卫生统计学系 100191
北京大学医学部美年公众健康研究院 100191
北京大学公众健康与重大疫情防控战略研究中心 100191 
 
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中文摘要:
      目的 分析中老年人群衰弱状态随时间的变化以及衰弱恶化的影响因素。方法 利用美兆健康体检中心的人群体检数据,纳入2008-2019年至少参加过2次体检且间隔>3年者,共13 689人。采用28个变量(包括疾病、症状、体格测量指标等)构建衰弱指数,衰弱指数≥ 0.25定义为衰弱,衰弱指数>0.10且<0.25为衰弱前期。按照首次体检时的衰弱状态进行分层分析,采用logistic回归模型探究社会人口学因素和生活方式特征对衰弱状态恶化的影响。结果 研究对象首次和末次体检时的年龄分别为(42.3±9.2)岁和(47.9±9.3)岁,首末次体检间隔时间为(5.7±1.9)年。首次体检时人群衰弱率和衰弱前期率分别为2.5%和50.3%,末次体检时分别上升至3.9%和55.4%。67.3%的研究对象在首末次体检时的衰弱状态保持不变,21.2%恶化,12.5%改善。在首次体检衰弱状态为健康的人群中,年龄大、女性、低文化程度、戒烟和每天吸烟、BMI定义的肥胖、以及腰臀比定义的中心性肥胖是衰弱状态恶化的危险因素。在首次体检为衰弱前期的人群中,年龄大、女性、BMI定义的肥胖、以及腰臀比定义的中心性肥胖是衰弱状态恶化的危险因素。结论 低文化程度、吸烟和肥胖等会增加个体衰弱恶化的风险。
英文摘要:
      Objective To evaluate the transitions of frailty status and related factors influencing its worsening in middle-aged and elderly adults. Methods Data was obtained from the Beijing MJ Health Screening Center. A total of 13 689 participants who attended health checkups at least twice during 2008-2019 and had more than three years' intervals during these two health checkups were included in the study. The frailty index comprising 28 variables was used to measure frailty status. Frailty was defined as frailty index ≥ 0.25, and prefrailty was defined as frailty index >0.10 and <0.25. Logistic regression analysis was performed to investigate the association of socio-demographic factors and lifestyle characteristics with the worsening of frailty status, stratified by frailty status at the first health checkup. Results The mean age at the first and last health checkups were (42.3±9.2) and (47.9±9.3) years, respectively. The mean interval during these two health checkups was (5.7±1.9) years. At the first health checkup, the prevalence of frailty and prefrailty were 2.5% and 50.3%, respectively. While at the last health checkup, the prevalence of frailty and prefrailty rose to 3.9% and 55.4%. Of all participants, 67.3% remained in the same frailty state, 21.2% worsening, and 12.5% improving. In robust participants at the first health checkup, older age, female, low education level, smoking cessation, daily smoking, being general obesity measured by BMI or central obesity measured by WHR showed an increased the risk of worsening frailty status. However, in prefrail participants at the first health checkup, older age, female, general, or central obesity presented as risk factors for worsening frailty status. Conclusion Modifiable factors such as low education level, smoking, and obesity may increase the risk of worsening frailty status.
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