Social and behavioural factors associated with frailty trajectories in a population-based cohort of older adults
Social and behavioural factors associated with frailty trajectories in a population-based cohort of older adults
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DOI：
10.1136/bmjopen-2016-011410
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发表时间：
2016-01-01
期刊：
影响因子：
2.9
通讯作者：
Rutten, Lila J. Finney
中科院分区：
文献类型：
--
作者：
Chamberlain, Alanna M.;St Sauver, Jennifer L.;Rutten, Lila J. Finney
目的本研究的目的是识别不同的脆弱轨迹研究目的：探讨老年人群中（随着时间的推移，虚弱程度相似的个体群），并确定与虚弱轨迹相关的社会和行为因素。设计基于人群的队列研究。研究地点：明尼苏达州奥姆斯特德县。参与者：明尼苏达州2005年60-89岁的居民。主要结果测量从2005年到2012年8年间虚弱的变化，通过构建年度虚弱指数来测量。脆弱的轨迹由十年的年龄，确定使用k-means聚类模型的纵向data.Results调整后的年龄和性别，所有的社会和行为因素（教育，婚姻状况，生活安排，吸烟状况和饮酒）显着相关的脆弱轨迹在那些年龄60-69和70- 79岁。在对基线虚弱进行进一步调整后，在60- 69岁的人群中，那些报告亲戚/朋友对饮酒的担忧的人（OR（95% CI）2.26（1.19至4.29））和那些受高中教育程度以下的人（OR（95% CI）1.98（1.32至2.96））处于高度虚弱轨迹的可能性最大。在70- 79奥尔兹的人群中，观察到最大的关联是那些担心自己饮酒的人。（OR（95% CI）1.92（1.23至3.00）），高中以下学历者（OR（95%CI）1.57（1.12 ~ 2.22）），与家人同住者（vs配偶; OR（95%CI）1.76（1.05 ~ 2.94））。没有因素仍然与脆弱的轨迹在80- 89 yearsolds调整基线frailty.Conclusions后，社会和行为因素与脆弱，在年轻的年龄观察到更强的协会。认识到与日益脆弱相关的社会和行为因素，可以为脆弱恶化风险的个体提供干预措施，特别是针对年轻个体。
Objective The goal of this study was to identify distinct frailty trajectories (clusters of individuals following a similar progression of frailty over time) in an ageing population and to determine social and behavioural factors associated with frailty trajectories.Design Population-based cohort study.Setting Olmsted County, Minnesota.Participants Olmsted County, Minnesota residents aged 60-89 in 2005.Primary outcome measure Changes in frailty over an 8-year period from 2005 to 2012, measured by constructing a yearly frailty index. Frailty trajectories by decade of age were determined using k-means cluster modelling for longitudinal data.Results After adjustment for age and sex, all social and behavioural factors (education, marital status, living arrangements, smoking status and alcohol use) were significantly associated with frailty trajectories in those aged 60-69 and 70-79years. After further adjustment for baseline frailty, the likelihood of being in the high frailty trajectory was greatest among those reporting concerns from relatives/friends about alcohol consumption (OR (95% CI) 2.26 (1.19 to 4.29)) and those with less than a high school education (OR (95% CI) 1.98 (1.32 to 2.96)) in the 60-69year olds. In the 70-79year olds, the largest associations were observed among those with concerns from oneself about alcohol consumption (OR (95% CI) 1.92 (1.23 to 3.00)), those with less than a high school education (OR (95% CI) 1.57 (1.12 to 2.22)), and those living with family (vs spouse; OR (95% CI) 1.76 (1.05 to 2.94)). No factors remained associated with frailty trajectories in the 80-89year olds after adjustment for baseline frailty.Conclusions Social and behavioural factors are associated with frailty, with stronger associations observed in younger ages. Recognition of social and behavioural factors associated with increasing frailty may inform interventions for individuals at risk of worsening frailty, specifically when targeted at younger individuals.