Frailty and risk of falls, fracture, and mortality in older women: The study of Osteoporotic fractures
Frailty and risk of falls, fracture, and mortality in older women: The study of Osteoporotic fractures
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DOI：
10.1093/gerona/62.7.744
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发表时间：
2007-07-01
影响因子：
5.1
通讯作者：
Cawthon, Peggy M.
中科院分区：
文献类型：
--
作者：
Ensrud, Kristine E.;Ewing, Susan K.;Cawthon, Peggy M.
背景在最近的一项老年人研究中，一个标准的虚弱表型与包括死亡率在内的不良结局风险增加有关。然而，这种表型对骨折结局和跨危险亚组的预测有效性尚不确定。为了确定标准的虚弱表型是否与老年女性不良健康后果的风险独立相关，并评估年龄和体重指数（BMI）定义的风险亚组之间相关性的一致性，我们确定了6724名年龄≥ 69岁的女性的虚弱状态，并前瞻性地随访了她们的意外福尔斯、骨折和死亡率。虚弱的定义是存在以下三个或三个以上的标准：无意的体重减轻，虚弱，自我报告的能量差，步行速度慢，体力活动少。事件复发性福尔斯定义为在随后一年内至少发生两次福尔斯。在平均9年的随访中确定了骨折事件（经X线片报告证实），包括髋部骨折和死亡。在控制了年龄、健康状况、医疗条件、功能状态、抑郁症状、认知功能和骨密度等多种混杂因素后，体弱女性随后发生复发性福尔斯的风险增加（多变量比值比= 1.38，95%置信区间[CI]，1.02-1.88），髋部骨折（多变量风险比[MHR] = 1.40，95% CI，1.03-1.90）、任何非脊柱骨折（MHR = 1.25，95% CI，1.05-1.49）和死亡（MHR = 1.82，95% CI，1.56-2.13）。虚弱和这些结果之间的联系在女性中持续存在！80年了此外，在不同BMI类别（包括BMI >= 30 k g/m 2）中，虚弱与福尔斯、骨折和死亡风险增加之间的相关性是一致的。虚弱是老年妇女（包括高龄妇女和老年肥胖妇女）不良健康结果的独立预测因素。
Background. A standard phenotype of frailty was associated with an increased risk of adverse outcomes including mortality in a recent study of older adults. However, the predictive validity of this phenotype for fracture outcomes and across risk subgroups is uncertain.Methods. To determine whether a standard frailty phenotype was independently associated with risk of adverse health outcomes in older women and to evaluate the consistency of associations across risk subgroups defined by age and body mass index (BMI), we ascertained frailty status in a cohort of 6724 women >= 69 years and followed them prospectively for incident falls, fractures, and mortality. Frailty was defined by the presence of three or more of the following criteria: unintentional weight loss, weakness, self-reported poor energy, slow walking speed, and low physical activity. Incident recurrent falls were defined as at least two falls during the subsequent year. Incident fractures (confirmed with x-ray reports), including hip fractures, and deaths were ascertained during an average of 9 years of follow-up.Results. After controlling for multiple confounders such as age, health status, medical conditions, functional status, depressive symptoms, cognitive function, and bone mineral density, frail women were subsequently at increased risk of recurrent falls (multivariate odds ratio = 1.38, 95% confidence interval [CI], 1.02-1.88), hip fracture (multivariate hazards ratio [MHR] = 1.40, 95% CI, 1.03-1.90), any nonspine fracture (MHR = 1.25, 95% Cl, 1.05-1.49), and death (MHR = 1.82, 95% CI, 1.56-2.13). The associations between frailty and these outcomes persisted among women ! 80 years. In addition, associations between frailty and an increased risk of falls, fracture, and mortality were consistently observed across categories of BMI, including BMI >= 30 k g/m(2).Conclusion. Frailty is an independent predictor of adverse health outcomes in older women, including very elderly women and older obese women.