Transitions between frailty states in the very old: the influence of socioeconomic status and multi-morbidity in the Newcastle 85+ cohort study.
Transitions between frailty states in the very old: the influence of socioeconomic status and multi-morbidity in the Newcastle 85+ cohort study.
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DOI：
10.1093/ageing/afaa054
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发表时间：
2020-10-23
期刊：
影响因子：
6.7
通讯作者：
Robinson L
中科院分区：
文献类型：
--
作者：
Mendonça N;Kingston A;Yadegarfar M;Hanson H;Duncan R;Jagger C;Robinson L
使用纽卡斯尔85+研究数据，我们调查了从85岁到90岁的虚弱状态之间的转换，以及多种疾病和社会经济地位（SES）是否会改变转换。纽卡斯尔85+研究是一项前瞻性、纵向队列研究，研究对象是1921年出生于纽卡斯尔和北泰恩赛德的所有人。数据包括：多维健康评估;一般实践记录审查（GPRR）和死亡日期。使用Fried表型（参与者定义为健壮，虚弱前或虚弱），在基线，18，36和60个月时测量虚弱程度。基线时，82%（696/845）的参与者可获得虚弱评分。在基线和所有后续时间点，女性（29.7%，123/414）的虚弱患病率高于男性（17.7%，50/282）。在基线时稳健的患者中，44.6%（50/112）在18个月时保持稳健，28%（14/50）在90岁时保持稳健。大多数人（52%）在连续的采访中保持相同的状态;只有6%的过渡是恢复（从虚弱到强壮或虚弱到虚弱），没有人从虚弱到强壮。四种或四种以上的疾病，即使在调整SES后，也有更大的可能性从健壮发展到虚弱前期。社会经济地位并不影响从一种脆弱状态转移到另一种脆弱状态的可能性。平均而言，85岁至90岁之间几乎有一半的时间处于虚弱前状态;多发病增加了从健壮发展到虚弱的机会;应鼓励在首次慢性病发作时加强临床干预，以防止向多发病过渡。
Using Newcastle 85+ Study data, we investigated transitions between frailty states from age 85 to 90 years and whether multi-morbidities and socioeconomic status (SES) modify transitions. The Newcastle 85+ Study is a prospective, longitudinal cohort study of all people born in 1921 in Newcastle and North Tyneside. Data included: a multidimensional health assessment; general practice record review (GPRR) and date of death. Using the Fried phenotype (participants defined as robust, pre-frail or frail), frailty was measured at baseline, 18, 36 and 60 months. Frailty scores were available for 82% (696/845) of participants at baseline. The prevalence of frailty was higher in women (29.7%, 123/414) than men (17.7%, 50/282) at baseline and all subsequent time points. Of those robust at baseline, 44.6% (50/112) remained robust at 18 months and 28% (14/50) at age 90. Most (52%) remained in the same state across consecutive interviews; only 6% of the transitions were recovery (from pre-frail to robust or frail to pre-frail), and none were from frail to robust. Four or more diseases inferred a greater likelihood of progression from robust to pre-frail even after adjustment for SES. SES did not influence the likelihood of moving from one frailty state to another. Almost half the time between age 85 and 90, on average, was spent in a pre-frail state; multi-morbidity increased the chance of progression from robust and to frail; greater clinical intervention at the onset of a first chronic illness, to prevent transition to multi-morbidity, should be encouraged.
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