Frailty and respiratory impairment in older persons.
Frailty and respiratory impairment in older persons.
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DOI：
10.1016/j.amjmed.2011.06.024
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发表时间：
2012-01
影响因子：
5.9
通讯作者：
Gill, Thomas M.
中科院分区：
文献类型：
--
作者：
Fragoso, Carlos A. Vaz;Enright, Paul L.;McAvay, Gail;Van Ness, Peter H.;Gill, Thomas M.
在老年人中，虚弱与肺活量测定确认的呼吸损伤之间的联系尚未得到评估。使用65-80岁白人参与者的数据(心血管健康研究，N=3,578)，我们评估了虚弱和呼吸损伤之间的横向和纵向关联，包括它们对死亡率的综合影响。基线评估包括虚弱状态(油炸表型；非虚弱、前期虚弱和虚弱)和肺活量测定。结果包括3岁时出现虚弱特征(前期虚弱或虚弱)，4岁时出现呼吸障碍(气流受限或限制性)，以及死亡(中位随访时间为13.2年)。在基线时，48.3%的人处于虚弱前期，5.8%的人虚弱，13.8%的人有气流受限，9.3%的人有限制性；46.1%的人随后死亡。在基线时，前衰弱和脆弱与气流受限调整的优势比(OR)(95%可信区间)分别为1.62(1.29，2.04)和1.88(1.15，3.09)，限制模式调整后的OR分别为1.80(1.37，2.36)和3.05(1.91，4.88)。纵向上，具有基线脆弱特征的参与者发生呼吸功能障碍的可能性增加，调整后的OR：1.42(1.11，1.82)。相反，有基线呼吸损伤的参与者发生脆弱特征的可能性增加-调整后的OR：1.58(1.17，2.13)。与非虚弱且没有呼吸损害的参与者相比，虚弱且有呼吸障碍的参与者的死亡率最高：3.91(2.93，5.22)。虚弱与呼吸损伤密切相关，当两者都存在时，会大大增加死亡风险。建立这些关联可以为旨在逆转或防止任一种情况的进展并减少不良后果的干预措施提供信息。
Among older persons, the association between frailty and spirometry-confirmed respiratory impairment has not yet been evaluated. Using data on white participants aged 65–80 years (Cardiovascular Health Study, N=3,578), we evaluated cross-sectional and longitudinal associations between frailty and respiratory impairment, including their combined effect on mortality. Baseline assessments included frailty status (Fried-phenotype; non-frail, pre-frail, and frail) and spirometry. Outcomes included development of frailty features (pre-frail or frail) at Year-3 and respiratory impairment (airflow limitation or restrictive-pattern) at Year-4, and death (median follow-up, 13.2 years). At baseline, 48.3% were pre-frail, 5.8% were frail, 13.8% had airflow limitation, and 9.3% had restrictive-pattern; 46.1% subsequently died. At baseline, pre-frail and frail were cross-sectionally associated with airflow limitation—adjusted odds ratio (OR) (95% confidence interval): 1.62 (1.29, 2.04) and 1.88 (1.15, 3.09), and restrictive-pattern—adjusted OR: 1.80 (1.37, 2.36) and 3.05 (1.91, 4.88), respectively. Longitudinally, participants with baseline frailty features had an increased likelihood of developing respiratory impairment―adjusted OR: 1.42 (1.11, 1.82). Conversely, participants with baseline respiratory impairment had an increased likelihood of developing frailty features—adjusted OR: 1.58 (1.17, 2.13). Mortality was highest among participants who were frail and had respiratory impairment—adjusted hazard ratio: 3.91 (2.93, 5.22), relative to those who were non-frail and had no respiratory impairment. Frailty and respiratory impairment are strongly associated with one another and substantially increase the risk of death when both are present. Establishing these associations may inform interventions designed to reverse or prevent the progression of either condition and to reduce adverse outcomes.
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影响因子：
24.3
作者：
Buch, P;Friberg, J;Prescott, E
通讯作者：
Prescott, E
影响因子：
6.2
作者：
Harrison, Robyn A.;Siminoski, Kerry;Majumdar, Sumit R.
通讯作者：
Majumdar, Sumit R.
影响因子：
5.8
作者：
Cawthon, Peggy M.;Ensrud, Kristine E.;Orwoll, Eric S.
通讯作者：
Orwoll, Eric S.
影响因子：
105.7
作者：
FLETCHER, C;PETO, R
通讯作者：
PETO, R
DOI：
10.1164/ajrccm.163.1.9906089
发表时间：
2001-01-01
影响因子：
24.7
作者：
Griffith, KA;Sherrill, DL;Enright, PL
通讯作者：
Enright, PL