Initial Manifestations of Frailty Criteria and the Development of Frailty Phenotype in the Women's Health and Aging Study II
Initial Manifestations of Frailty Criteria and the Development of Frailty Phenotype in the Women's Health and Aging Study II
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DOI：
10.1093/gerona/63.9.984
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发表时间：
2008-09-01
影响因子：
5.1
通讯作者：
Fried, Linda P.
中科院分区：
文献类型：
--
作者：
Xue, Qian-Li;Bandeen-Roche, Karen;Fried, Linda P.
背景。了解脆弱综合征的发病点对于早期识别高危个体和针对最初受影响的部分进行干预至关重要，此时最有可能逆转。本研究旨在描述常用的虚弱标准所体现的自然史特征，并评估进展到虚弱的速度是否取决于最初的表现。这项调查是基于一项为期7.5年的观察性研究，研究对象是420名年龄在70-79岁之间的社区妇女，她们在基线时并不虚弱，虚弱的定义是满足5个标准中的>= 3：体重减轻、步行速度慢、虚弱、疲惫和低体力活动水平。在基线时不虚弱的妇女中，7.5年的虚弱发生率为9%。尽管存在显著的异质性，但虚弱是最常见的第一表现，在基线时非虚弱的女性中，76%的人在疲惫和体重减轻之前会出现虚弱、迟缓和低体力活动。以疲劳或体重减轻为首发症状的妇女比没有任何标准的妇女变得虚弱的可能性高3-5倍（p < 0.05）。我们的研究结果表明，在早期虚弱的发展中，虚弱可能是一个日益脆弱的警告信号，体重减轻和疲惫可能有助于识别女性最容易出现快速不良进展的风险。
Background. Understanding points of onset of the frailty syndrome is vital to early identification of at-risk individuals and to targeting intervention efforts to those components that are first affected, when reversal may be most possible. This study aims to characterize natural history by which commonly used frailty criteria manifest and to assess whether the rate of progression to frailty depends on initial manifestations.Methods. The investigation was based on a 7.5-year observational study of 420 community-dwelling women aged 70-79 years who were not frail at baseline, with frailty defined as meeting >= 3 of 5 criteria: weight loss, slow walking speed, weakness, exhaustion, and low physical activity level.Results. The 7.5-year incidence of frailty was 9% among women who were nonfrail at baseline. Despite significant heterogeneity, weakness was the most common first manifestation, and occurrence of weakness, slowness, and low physical activity preceded exhaustion and weight loss in 76% of the women who were nonfrail at baseline. Women with exhaustion or weight loss as initial presenting symptoms were 3-5 times more likely to become frail than were women without any criterion (p < .05).Conclusions. Our findings suggest that weakness may serve as a warning sign of increasing vulnerability in early frailty development, and weight loss and exhaustion may help to identify women most at risk for rapid adverse progression.