社区老年人衰弱状态的过渡及其恶化影响因素分析的前瞻性研究

杨帆; 王双; 覃海; 谭柯; 孙倩倩; 王凌霄; 聂双双; 刘佳倪; 陈杨; 张敏; 陈燕语

Abstract

杨帆,王双,覃海,谭柯,孙倩倩,王凌霄,聂双双,刘佳倪,陈杨,张敏,陈燕语.社区老年人衰弱状态的过渡及其恶化影响因素分析的前瞻性研究[J].Chinese journal of Epidemiology,2019,40(2):186-190

社区老年人衰弱状态的过渡及其恶化影响因素分析的前瞻性研究

Frailty progress and related factors in the elderly living in community: a prospective study

Received:June 13, 2018

DOI：10.3760/cma.j.issn.0254-6450.2019.02.012

KeyWord: 衰弱综合征社区过渡危险因素

English Key Word: Frailty Community Progress Risk factor

FundProject:四川省卫生和计划生育委员会重点课题（16ZD001）；强生全球创新课题（H1312124）

Author Name	Affiliation	E-mail
Yang Fan	Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China
Wang Shuang	Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China	wangs0211@hotmail.com
Qin Hai	Internal Medicine Department, Pingyi Community Health Service Center in Dujiangyan, Dujiangyan 610000, China
Tan Ke	Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China
Sun Qianqian	Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China
Wang Lingxiao	Geriatric Department, the Fifth People's Hospital of Chengdu, Chengdu 611130, China
Nie Shuangshuang	General Medicine Department, the Affiliated Central Hospital of Qingdao University, Qingdao 266071, China
Liu Jiani	Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China
Chen Yang	Department of Palliative Medicine, the Fourth West China Teaching Hospital, Sichuan University, Chengdu 610041, China
Zhang Min	Department of Elderly Endocrinology, Sichuan Provincial People's Hospital, Chengdu 610072, China
Chen Yanyu	Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China

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Abstract:

目的探讨社区老年人衰弱状态的过渡情况，以及衰弱状态恶化的影响因素。方法在四川省都江堰市平义社区建立≥ 65岁老年人队列，分别于2014年1月和2017年1月进行面对面问卷调查，内容包括衰弱状态、认知功能、营养状况和功能状态等。采用二元logistic回归分析衰弱状态恶化的影响因素。结果 2014年1月调查了653名老年人，2017年1月进行随访，146名失访，共对507名老年人进行分析。基线调查时衰弱和衰弱前期的患病率分别为11.2%（57人）和26.2%（133人）。3年后，205名（40.4%）老年人衰弱状态恶化，276名（54.5%）老年人保持不变，26名（5.1%）老年人衰弱状态改善。在校正基线衰弱状态后，失能（OR=8.27，95% CI：1.62~42.26）、视力障碍（OR=2.02，95% CI：1.27~3.22）、认知功能障碍（OR=1.94，95% CI：1.08~3.48）、自评健康状态差（OR=1.89，95% CI：1.07~3.31）、慢性疼痛（OR=1.57，95% CI：1.03~2.40）和年龄（OR=1.12，95% CI：1.08~1.17）是衰弱状态恶化的危险因素；而超重是衰弱状态恶化的保护因素（OR=0.54，95% CI：0.34~0.85）。结论衰弱是一种动态综合征，失能、视力障碍、认知功能障碍、自评健康状态差、慢性疼痛和年龄是衰弱状态恶化的独立危险因素，而超重是其保护因素。

English Abstract:

Objective To investigate frailty progress status and related factors in the elderly living in communities. Methods A cohort of elderly people aged 65 and over in Pingyi community of Dujiangyan, Sichuan province, was established. Face-to-face questionnaire survey was conducted by trained interviewers. The frailty status, cognitive function, nutrition status and other functions of the subjects surveyed were evaluated at baseline survey and during follow-up. The socio-demographic and clinical characteristics of the subjects surveyed were assessed at baseline survey. Binary logistic regressions were used to identify factors associated with frailty progress. Results A total of 653 elderly people were surveyed in January 2014, and 507 elderly people were followed up while 146 elderly people terminated further follow-up in January 2017. The prevalence rates of frailty and pre-frailty at baseline survey were 11.2% (n=57) and 26.2% (n=133), respectively. After 3 years, 205 subjects (40.4%) surveyed experienced frailty progress, 276 (54.5%) remained to be in frailty state at baseline survey, and 26 (5.1%) had improvement. Disability (OR=8.27, 95% CI:1.62-42.26), visual problem (OR=2.02, 95% CI:1.27-3.22), cognitive impairment (OR=1.94, 95% CI:1.08-3.48), poor self-rated health (OR=1.89, 95% CI:1.07-3.31), chronic pain (OR=1.57, 95% CI:1.03-2.40) and older age (OR=1.12, 95% CI:1.08-1.17) were independently associated with the progress of frailty. In contract, overweight was a protective factor (OR=0.54, 95% CI:0.34-0.85). Conclusions Frailty is a dynamic syndrome affected by several socio-demographic factors and geriatric factors. The results of the study can be used in the prevention of frailty progress in the elderly in communities.

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