Validation and Comparison of Two Frailty Indexes: The MOBILIZE Boston Study
Validation and Comparison of Two Frailty Indexes: The MOBILIZE Boston Study
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DOI：
10.1111/j.1532-5415.2009.02394.x
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发表时间：
2009-09-01
影响因子：
6.3
通讯作者：
Lipsitz, Lewis A.
中科院分区：
文献类型：
--
作者：
Kiely, Dan K.;Cupples, L. Adrienne;Lipsitz, Lewis A.
目的：验证两种已确立的衰弱指数，并比较它们在一个多样化的老年社区居住男女样本中预测不良结局的能力。
设计：前瞻性观察研究。
地点：波士顿一个明确划分的多样化地理区域。
参与者：波士顿老年人平衡、独立生活、智力和活力维持研究中的765名社区居住参与者。
测量指标：两种已发表的衰弱指数、反复跌倒、残疾、夜间住院、急诊室（ED）就诊、慢性疾病状况、自我报告的健康状况、身体功能、认知能力（包括执行功能）以及抑郁。一种指数源自骨质疏松性骨折研究（SOF），另一种源自心血管健康研究（CHS）。
结果：SOF衰弱指数将77.1%归类为健壮，18.7%为衰弱前期，4.2%为衰弱。CHS衰弱指数将51.2%归类为健壮，38.8%为衰弱前期，10.0%为衰弱。两种衰弱指数（SOF；CHS）在预测关键的老年病结局方面能力相似，例如反复跌倒（危险比（HR）（衰弱）=2.2，95%置信区间（CI）=1.2 - 4.0；HR（衰弱）=1.9，95%CI = 1.2 - 3.1）、夜间住院（比值比（OR）（衰弱）3.5，95%CI = 1.5 - 8.0；OR（衰弱）=4.4，95%CI = 2.4 - 8.2）、急诊室就诊（OR（衰弱）=3.5，95%CI = 1.4，8.8；OR（衰弱）=3.1，95%CI = 1.6 - 5.9）以及残疾（OR（衰弱）=5.4，95%CI = 2.3 - 12.3；OR（衰弱）=7.7，95%CI = 4.0 - 14.7），还有慢性疾病状况、身体功能、认知能力和抑郁。
结论：使用一个多样化的独立老年男女样本验证了两种已确立的衰弱指数；两种指数都能很好地区分老年病状况，并根据衰弱程度预测反复跌倒、夜间住院和急诊室就诊。尽管两种指数都是衡量衰弱的良好指标，但更简单的SOF指数在临床环境中可能更容易且更实用。《美国老年医学会杂志》2009年57卷1532 - 1539页
OBJECTIVES: To validate two established frailty indexes and compare their ability to predict adverse outcomes in a diverse, elderly, community-dwelling sample of men and women.DESIGN: Prospective observational study.SETTING: A diverse defined geographic area of Boston.PARTICIPANTS: Seven hundred sixty-five community-dwelling participants in the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly Boston Study.MEASUREMENTS: Two published frailty indexes, recurrent falls, disability, overnight hospitalization, emergency department (ED) visits, chronic medical conditions, self-reported health, physical function, cognitive ability (including executive function), and depression. One index was developed from the Study of Osteoporotic Fractures (SOF) and the other from the Cardiovascular Health Study (CHS).RESULTS: The SOF frailty index classified 77.1% as robust, 18.7% as prefrail, and 4.2% as frail. The CHS frailty index classified 51.2% as robust, 38.8% as prefrail, and 10.0% as frail. Both frailty indexes (SOF; CHS) were similar in their a ability to predict key geriatric outcomes such as recurrent falls (hazard ratio (HR)(frail) = 2.2, 95% confidence interval (CI) = 1.2-4.0; HRfrail = 1-9, 95% Cl 1.2-3.1), overnight hospitalization (odds ratio (OR)(frail) 3.5, 95% CI = 1.5-8.0; ORfrail = 4.4, 95% CI = 2.4-8.2), ED visits (ORfrail = 3.5, 95% CI = 1.4,8.8; ORfrail = 3.1, 95% CI = 1.6-5.9), and disability (ORfrail = 5.4, 95% Cl = 2.3-12.3; ORfrail = 7.7, 95% CI = 4.0-14.7), as well as chronic medical conditions, physical function, cognitive ability, and depression.CONCLUSION: Two established frailty indexes were validated using an independent elderly sample of diverse men and women; both indexes were good at distinguishing geriatric conditions and predicting recurrent falls, overnight hospitalization, and ED visits according to level of frailty. Although both indexes are good measures of frailty, the simpler SOF index may be easier and more practical in a clinical setting. J Am Geriatr Soc 57:1532-1539, 2009.