Impact of physical frailty on disability in community-dwelling older adults: a prospective cohort study.
Impact of physical frailty on disability in community-dwelling older adults: a prospective cohort study.
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DOI：
10.1136/bmjopen-2015-008462
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发表时间：
2015-09-02
期刊：
影响因子：
2.9
通讯作者：
Suzuki T
中科院分区：
文献类型：
--
作者：
Makizako H;Shimada H;Doi T;Tsutsumimoto K;Suzuki T
研究身体虚弱与残疾风险之间的关系，并确定对社区老年人残疾影响最大的脆弱成分(S)。前瞻性队列研究。一个日本社区。4,341名居住在该社区的≥65岁老年人参加了2011-2012年的基线评估，并被跟踪了2个 年。日本国家长期护理保险系统中的护理需要认证，身体虚弱的类型(健壮、早衰、虚弱)和子项(迟缓、虚弱、疲惫、低活动量、体重减轻)，根据人口特征等几个潜在的混杂因素进行调整，用Kaplan-Meier生存曲线分析按虚弱表型划分的残疾发生率。在两年的随访期内，168名参与者(3.9%)开始使用LTCI系统来监测残疾发生率。在基线评估中被归类为虚弱(HR 4.65，95%CI 2.63至8.22)或早衰者(2.52，1.56至4.07)的参与者与健壮的参与者相比，残疾发生率的风险更高。对脆弱分项的分析表明，迟缓(2.32，1.62至3.33)、虚弱(1.90，1.35至2.68)和体重减轻(1.61，1.13至2.31)与残疾发生率的增加相关。在分层分析中，在基线评估后的2 年中，被归类为虚弱和认知功能较低的参与者的残疾发生率最高(30.3%)。身体虚弱，即使是身体虚弱，也会对未来的残疾风险产生强烈的影响。一些虚弱的成分，如行动迟缓、虚弱和体重减轻，与居住在社区的老年人的意外残疾密切相关。
To examine the relationship between physical frailty and risk of disability, and to identify the component(s) of frailty with the most impact on disability in community-dwelling older adults. Prospective cohort study. A Japanese community. 4341 older adults aged ≥65 living in the community participated in a baseline assessment from 2011 to 2012 and were followed for 2 years. Care-needs certification in the national long-term care insurance (LTCI) system of Japan, type of physical frailty (robust, prefrail, frail) and subitems (slowness, weakness, exhaustion, low activity, weight loss), adjusted for several potential confounders such as demographic characteristics, analysed with Kaplan-Meier survival curves for incidence of disability by frailty phenotype. During the 2-year follow-up period, 168 participants (3.9%) began using the LTCI system for incidence of disability. Participants classified as frail (HR 4.65, 95% CI 2.63 to 8.22) or prefrail (2.52, 1.56 to 4.07) at the baseline assessment had an increased risk of disability incidence compared with robust participants. Analyses for subitems of frailty showed that slowness (2.32, 1.62 to 3.33), weakness (1.90, 1.35 to 2.68) and weight loss (1.61, 1.13 to 2.31) were related to increased risk of disability incidence. In stratified analyses, participants who were classified as frail and who had lower cognitive function had the highest percentage (30.3%) of disability incidence during the 2 years after baseline assessment. Physical frailty, even being prefrail, had a strong impact on the risk of future disability. Some components of frailty, such as slowness, weakness and weight loss, are strongly associated with incident disability in community-dwelling older adults.