Early frailty transition predicts 15-year mortality among nondisabled older Mexican Americans
Early frailty transition predicts 15-year mortality among nondisabled older Mexican Americans
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DOI：
10.1016/j.annepidem.2018.03.021
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发表时间：
2018-06-01
影响因子：
5.6
通讯作者：
Ottenbacher, Kenneth J.
中科院分区：
文献类型：
--
作者：
Li, Chih-Ying;Al Snih, Soham;Ottenbacher, Kenneth J.
目的：调查早期脆弱的转变对15年的死亡率risk.Methods的影响：纵向数据分析的西班牙裔建立人口的流行病学研究的老年人，涉及1171社区居住的墨西哥裔美国人年龄≥ 67岁及以上。使用改良的虚弱表型确定虚弱，包括无意的体重减轻、虚弱、自我报告的疲惫和缓慢的步行速度。参与者被定义为在基线为nonfraith，prefraith，或体弱，并分为9个过渡组，在3年的观察periods.Results：平均年龄为77.0岁（标准差[SD] = 5.3）和59.1%的女性。从虚弱前期过渡到虚弱的参与者（风险比[HR] = 1.68，95%置信区间[CI] = 1.23-2.28），虚弱至虚弱前期（HR = 1.54，95%CI = 1.05-2.28）;或保持虚弱（HR = 1.72，95%CI = 1.21 - 2.44）的患者的15年死亡风险显著高于保持非虚弱的患者。从虚弱过渡到非虚弱的参与者与保持非虚弱的参与者具有相似的15年死亡风险（HR = 0.96，95%CI = 0.53-1.72）。体重减轻和缓慢的步行速度与过渡到frailty.Conclusions：早期过渡从体弱到nonfrailty在老年墨西哥裔美国人与死亡率下降4%，与那些谁仍然nonfrailty相比，虽然这种差异没有统计学意义。需要额外的纵向研究来了解虚弱的积极转变。(C)2018爱思唯尔公司All rights reserved.
Purpose: To investigate the effect of early frailty transitions on 15-year mortality risk.Methods: Longitudinal data analysis of the Hispanic Established Populations for the Epidemiological Study of the Elderly involving 1171 community-dwelling Mexican Americans aged >= 67 years and older. Frailty was determined using the modified frailty phenotype, including unintentional weight loss, weakness, self-reported exhaustion, and slow walking speed. Participants were defined at baseline as nonfrail, prefrail, or frail and divided into nine transition groups, during a 3-year observation period.Results: Mean age was 77.0 years (standard deviation [SD] = 5.3) and 59.1% were female. Participants who transitioned from prefrail to frail (hazard ratio [HR] = 1.68, 95% confidence interval [CI] = 1.23-2.28), frail to prefrail (HR = 1.54, 95% CI = 1.05-2.28); or who remained frail (HR = 1.72, 95% CI = 1.21 -2.44), had significant higher 15-year mortality risk than those who remained nonfrail. Participants transitioning from frail to nonfrail had a similar 15-year mortality risk as those who remained nonfrail (HR = 0.96, 95% CI = 0.53-1.72). Weight loss and slow walking speed were associated with transitions to frailty.Conclusions: An early transition from frail to nonfrail in older Mexican Americans was associated with a 4% decrease in mortality compared with those who remained nonfrail, although this difference was not statistically significant. Additional longitudinal research is needed to understand positive transitions in frailty. (C) 2018 Elsevier Inc. All rights reserved.