Transitions in frailty status in older adults in relation to mobility: a multistate modeling approach employing a deficit count.
Transitions in frailty status in older adults in relation to mobility: a multistate modeling approach employing a deficit count.
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DOI：
10.1111/j.1532-5415.2011.03300.x
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发表时间：
2011-03
影响因子：
6.3
通讯作者：
Rockwood K
中科院分区：
文献类型：
--
作者：
Fallah N;Mitnitski A;Searle SD;Gahbauer EA;Gill TM;Rockwood K
调查脆弱状态和死亡风险的变化与基线脆弱状态、活动能力、年龄和性别的关系。耶鲁大学降水事件项目，这是一项基于康涅狄格州纽黑文的队列研究。754名社区居民，基线年龄70岁以上，分别在18、36和54个月进行了随访。每隔18个月评估一次的脆弱状态由脆弱指数定义，即36个健康变量中的缺陷数量。移动性被定义为在快速步态测试中以秒为单位的时间，参与者以尽可能快的速度在20英尺的赛道上来回走动。存活和死亡患者的多态转移概率分别由基线脆弱度、活动能力、年龄和性别通过泊松和Logistic回归进行计算。在多变量分析中，基线脆弱状态和年龄与脆弱状态的改变和死亡风险显著相关，而流动性与前者显著相关，但与死亡率无关。在脆弱指数的所有值上，与流动性较差的参与者相比，流动性较好的参与者更有可能保持稳定或有所改善。例如，54个月时，行动能力较差的参与者20.6%(95%可信区间=16-25.2)的缺陷与活动能力较好的参与者的32.4%(95%CI=27.9-36.9)相同或更少。一个多状态转换模型有效地衡量了脆弱状态和死亡风险的变化概率。机动性、年龄和基线脆弱是脆弱状态转变的重要因素。
To investigate how changes in frailty status and mortality risk relate to baseline frailty state, mobility performance, age and sex. The Yale Precipitating Events Project, a cohort study based in New Haven CT. 754 community-dwelling people, aged 70+ years at baseline followed-up at 18, 36 and 54 months. Frailty status, assessed at 18-month intervals, was defined by a frailty index, as the number of deficits in 36 health variables. Mobility was defined as the time in seconds on the rapid gait test, where participants walked back and forth over a 20-ft course as quickly as possible. Multi-state transition probabilities were calculated with baseline frailty, mobility, age and sex estimated by Poisson and logistic regressions in survivors and those who died, respectively. In multivariable analyses, baseline frailty status and age were significantly associated with changes in frailty status and the risk of death, while mobility was significantly associated with the former, but not with mortality. At all values of the frailty index, compared to those with poor mobility, participants with better mobility were more likely to remain stable or to improve. For example, at 54 months, 20.6% (95% confidence interval (CI) =16–25.2) of participants with poor mobility had the same or fewer deficits compared to 32.4% (95% CI=27.9–36.9) of those with better mobility. A multi-state transition model effectively measured the probability of changes in frailty status and in the risk of death. Mobility, age and baseline frailty were significant factors in frailty state transitions.
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DOI：
10.1111/j.1532-5415.2007.01603.x
发表时间：
2008-03-01
影响因子：
6.3
作者：
Gill, Thomas M.;Guo, Zhenchao;Allore, Heather G.
通讯作者：
Allore, Heather G.
DOI：
10.1111/j.1532-5415.2005.00586.x
发表时间：
2006-02-01
影响因子：
6.3
作者：
Gill, TM;Allore, HG;Guo, ZC
通讯作者：
Guo, ZC
DOI：
10.1093/gerona/60.8.1046
发表时间：
2005-08-01
影响因子：
5.1
作者：
Goggins, WB;Woo, J;Ho, SC
通讯作者：
Ho, SC
影响因子：
3.9
作者：
Mitnitski, Arnold;Song, Xiaowei;Rockwood, Kenneth
通讯作者：
Rockwood, Kenneth
影响因子：
3.7
作者：
Hubbard RE;Fallah N;Searle SD;Mitnitski A;Rockwood K
通讯作者：
Rockwood K