Transitions in Frailty States Among Community-Living Older Adults and Their Associated Factors
Transitions in Frailty States Among Community-Living Older Adults and Their Associated Factors
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DOI：
10.1016/j.jamda.2013.12.002
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发表时间：
2014-04-01
影响因子：
7.6
通讯作者：
Woo, Jean
中科院分区：
文献类型：
--
作者：
Lee, Jenny S. W.;Auyeung, Tung-Wai;Woo, Jean
背景：虚弱使老年人更容易出现不良的健康结果。很少有关于不同脆弱状态之间的转换的报道。我们试图检查这些转变的速度及其相关因素。方法：我们招募了3018名65岁及以上的中国社区生活成年人。在间隔2年的2次访问中，根据Fried标准对虚弱状态进行分类。记录了人口统计数据、医疗条件、住院情况和认知情况。研究了转换速率和相关因素。结果：基线时，850名男性（48.7%）和884名女性（52.6%）为易患病。其中，23.4%的男性和26.6%的女性在2年后有所改善；11.1%的男性和6.6%的女性病情加重。男性多于女性（P < 0.001）恶化为虚弱。住院治疗、年龄较大、既往中风、认知能力低下和骨关节炎是体弱参与者衰退的危险因素。患有糖尿病的女性改善的几率要低50%。在健壮者中，年龄较大和既往癌症、住院、慢性肺部疾病和中风是病情恶化的危险因素。较高的社会经济地位具有保护作用。在身体虚弱的男性中，先前的中风使改善的机会降低了78%。对于身体虚弱的女性来说，只有年龄越小，情况越好。结论：与男性相比，女性较不容易出现衰弱状态的下降。住院、年龄较大、既往中风、认知功能低下、糖尿病和骨关节炎与病情恶化或改善程度较低相关。年龄较大、既往癌症、住院、肺部疾病和中风是健康恶化的危险因素，较高的社会经济地位具有保护作用。(C) 2014 - American Medical Directors Association, Inc.；版权所有。
Background: Frailty renders older individuals more prone to adverse health outcomes. Little has been reported about the transitions between the different frailty states. We attempted to examine the rate of these transitions and their associated factors.Methods: We recruited 3018 Chinese community-living adults 65 years or older. Frailty status was classified according to the Fried criteria in 2 visits 2 years apart. Demographic data, medical conditions, hospitalizations, and cognition were recorded. Rates of transitions and associated factors were studied.Results: At baseline, 850 (48.7%) men and 884 (52.6%) women were prefrail. Among these, 23.4% men and 26.6% women improved after 2 years; 11.1% of men and 6.6% of women worsened. More men than women (P < .001) deteriorated into frailty. Hospitalizations, older age, previous stroke, lower cognition, and osteoarthritis were risk factors for decline among prefrail participants. Having diabetes was associated with 50% lower chance of improvement in women. Among the robust, older age and previous cancer, hospitalizations, chronic lung diseases, and stroke were risk factors for worsening. Higher socioeconomic status was protective. Previous stroke reduced the chance of improvement by 78% in frail men. Only younger age was associated with improvement in frail women.Conclusion: Women were less likely to decline in frailty status than men. Hospitalizations, older age, previous stroke, lower cognitive function, diabetes, and osteoarthritis were associated with worsening or less improvement. Older age, previous cancer, hospitalizations, lung diseases, and stroke were risk factors for worsening in the robust and higher socioeconomic status was protective. (C) 2014 - American Medical Directors Association, Inc. All rights reserved.