Determinants of frailty: the added value of assessing medication.
Determinants of frailty: the added value of assessing medication.
复制标题
虚弱的决定因素：评估药物的附加值。
DOI：
10.3389/fnagi.2015.00056
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发表时间：
2015
影响因子：
4.8
通讯作者：
Fernandes L
中科院分区：
文献类型：
--
作者：
Coelho T;Paúl C;Gobbens RJ;Fernandes L
本研究旨在分析哪些决定因素可以预测总体上的脆弱性以及每个脆弱性领域（生理、心理和社会），考虑到脆弱性的整体概念模型，特别是检查药物在这种预测中的贡献。横断面研究采用了来自葡萄牙三个城市的252名社区居住老年人的非概率样本。虚弱和虚弱的决定因素用蒂尔堡虚弱指标进行评估。研究人员还检查了不同日常用药的数量和类型。进行层次回归分析。参与者平均年龄为79.2岁（±7.3岁），以女性（75.8%）、丧偶（55.6%）和低文化程度（0-4岁：63.9%）居多。在这项研究中，决定因素解释了46%的总脆弱性方差，以及39.8%、25.3%和27.7%的身体、心理和社会脆弱性方差。年龄、性别、收入、过去一年亲人的死亡、生活方式、对生活环境的满意度和自我报告的合并症预测了总体脆弱性，而每个脆弱性领域都与一组不同的决定因素相关。每日消耗的药物数量与身体虚弱独立相关，心血管系统和血液及造血器官的药物消耗解释了总体和身体虚弱的部分差异。多种药物的不良反应及其与合并症水平的直接联系可以解释处方药物数量对衰弱预测的独立贡献。另一方面，关于药物类型的研究结果进一步证明了虚弱与心血管风险的关联。在本研究中，对脆弱性的重要部分进行了预测，并且每个决定因素对脆弱性域的不同贡献突出了脆弱性整体模型的相关性。简单的药物评估的附加价值是相当大的，它应该被考虑到有效地识别虚弱。
This study aims to analyze which determinants predict frailty in general and each frailty domain (physical, psychological, and social), considering the integral conceptual model of frailty, and particularly to examine the contribution of medication in this prediction. A cross-sectional study was designed using a non-probabilistic sample of 252 community-dwelling elderly from three Portuguese cities. Frailty and determinants of frailty were assessed with the Tilburg Frailty Indicator. The amount and type of different daily-consumed medication were also examined. Hierarchical regression analysis were conducted. The mean age of the participants was 79.2 years (±7.3), and most of them were women (75.8%), widowed (55.6%) and with a low educational level (0–4 years: 63.9%). In this study, determinants explained 46% of the variance of total frailty, and 39.8, 25.3, and 27.7% of physical, psychological, and social frailty respectively. Age, gender, income, death of a loved one in the past year, lifestyle, satisfaction with living environment and self-reported comorbidity predicted total frailty, while each frailty domain was associated with a different set of determinants. The number of daily-consumed drugs was independently associated with physical frailty, and the consumption of medication for the cardiovascular system and for the blood and blood-forming organs explained part of the variance of total and physical frailty. The adverse effects of polymedication and its direct link with the level of comorbidities could explain the independent contribution of the amount of prescribed drugs to frailty prediction. On the other hand, findings in regard to medication type provide further evidence of the association of frailty with cardiovascular risk. In the present study, a significant part of frailty was predicted, and the different contributions of each determinant to frailty domains highlight the relevance of the integral model of frailty. The added value of a simple assessment of medication was considerable, and it should be taken into account for effective identification of frailty.