Frailty in Older Adults: A Nationally Representative Profile in the United States
Frailty in Older Adults: A Nationally Representative Profile in the United States
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DOI：
10.1093/gerona/glv133
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发表时间：
2015-11-01
影响因子：
5.1
通讯作者：
Kasper, Judith D.
中科院分区：
文献类型：
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作者：
Bandeen-Roche, Karen;Seplaki, Christopher L.;Kasper, Judith D.
脆弱性评估提供了一种确定老年人最容易受到不良后果影响的手段。在临床实践中关注虚弱更有可能更好地了解其患病率和与患者特征的关联。Fried及其同事提出的一种流行的、经过验证的虚弱表型被应用于2011年国家健康和老龄化趋势研究的7,439名参与者，这是一项针对65岁及以上人群的国家纵向研究。所有措施都是通过两个小时的面对面访谈得出的。15%（95%CI：14%，16%）的老年非疗养院人群是虚弱的，45%是虚弱前期（95%CI：44%，47%）。在老年人、妇女、少数种族和族裔、在支助性住宅环境中的人以及低收入者中，虚弱更为普遍。独立于这些特征，虚弱患病率在地理区域之间差异很大。慢性病和残疾患病率随着身体虚弱而急剧增加。在体弱者中，42%的人在前一年住院，相比之下，体弱者为22%，被认为强壮的人为11%。去年的髋关节、背部和心脏手术与虚弱有关。我们的研究结果支持了虚弱在晚年健康病因学中的重要性，以及虚弱作为不良健康结果风险标志的潜在价值，并作为确定临床实践和公共卫生政策干预机会的一种手段。
Frailty assessment provides a means of identifying older adults most vulnerable to adverse outcomes. Attention to frailty in clinical practice is more likely with better understanding of its prevalence and associations with patient characteristics. We sought to provide national estimates of frailty in older people.A popular, validated frailty phenotype proposed by Fried and colleagues was applied to 7,439 participants in the 2011 baseline of the National Health and Aging Trends Study, a national longitudinal study of persons aged 65 and older. All measures drew on a 2-hour in-person interview. Weighted estimates of frailty prevalence were obtained.Fifteen percent (95% CI: 14%, 16%) of the older non-nursing home population is frail, and 45% is prefrail (95% CI: 44%, 47%). Frailty is more prevalent at older ages, among women, racial and ethnic minorities, those in supportive residential settings, and persons of lower income. Independently of these characteristics, frailty prevalence varies substantially across geographic regions. Chronic disease and disability prevalence increase steeply with frailty. Among the frail, 42% were hospitalized in the previous year, compared to 22% of the prefrail and 11% of persons considered robust. Hip, back, and heart surgery in the last year were associated with frailty. Over half of frail persons had a fall in the previous year.Our findings support the importance of frailty in late-life health etiology and potential value of frailty as a marker of risk for adverse health outcomes and as a means of identifying opportunities for intervention in clinical practice and public health policy.