Frailty transitions and types of death in Chinese older adults: a population-based cohort study.
Frailty transitions and types of death in Chinese older adults: a population-based cohort study.
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中国老年人的衰弱转变和死亡类型：一项基于人群的队列研究
DOI：
10.2147/cia.s157089
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发表时间：
2018
影响因子：
3.6
通讯作者：
Hai H
中科院分区：
文献类型：
--
作者：
Liu ZY;Wei YZ;Wei LQ;Jiang XY;Wang XF;Shi Y;Hai H
背景关于脆弱转变的不利影响知之甚少。在这项研究中，我们的目的是描述脆弱状态之间的转换，并研究它们与中国老年人死亡类型的关系，中国是一个人口老龄化迅速增长的发展中国家。方法我们使用了2002年和2005年中国健康长寿纵向调查（CLHLS）的11,165名老年人（年龄65-99岁）的数据。总体而言，44个健康缺陷被用于构建脆弱指数（FI;范围：0-1），然后将其分为三个级别的变量：非脆弱（FI ≤0.10），脆弱前（0.10< FI ≤0.21）和脆弱（FI >0.21）。结果是基于卧床天数和痛苦状态的四种类型的死亡（在2008年CLHLS浪潮中评估）。结果在3年期间，3,394名（30.4%）参与者在不同的虚弱状态（非虚弱，虚弱前和虚弱）之间过渡，三分之一过渡到死亡，三分之一保持在以前的虚弱状态。向更严重虚弱的转变（即“恶化”）比向较轻虚弱的转变（即“改善”）更常见。在四种虚弱转变类别中，“恶化”和“保持虚弱”增加了疼痛性死亡的风险，例如，4型死亡（即死亡前卧床不起≥30天）的比值比分别为1.92（95%置信区间[CI] =1.41，2.62）和4.75（95% CI =3.32，6.80）。结论中国老年人体质虚弱是一个动态的过程，具有频繁的转变类型。此外，那些仍然虚弱的人最有可能经历痛苦的死亡，这引起了对虚弱人群生活质量的关注。
Background Little is known about the adverse effects of frailty transitions. In this study, we aimed to characterize the transitions between frailty states and examine their associations with the type of death among older adults in China, a developing country with a rapidly growing aging population. Methods We used data of 11,165 older adults (aged 65–99 years) from the 2002 and 2005 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Overall, 44 health deficits were used to construct frailty index (FI; range: 0–1), which was then categorized into a three-level variable: nonfrail (FI ≤0.10), prefrail (0.10< FI ≤0.21), and frail (FI >0.21). Outcome was four types of death based on bedridden days and suffering state (assessed in the 2008 wave of CLHLS). Results During the 3-year period, 3,394 (30.4%) participants had transitioned between different frailty states (nonfrail, prefrail, and frail), one-third transitioned to death, and one-third remained in previous frailty states. Transitions to greater frailty (ie, “worsening”) were more common than transitions to lesser frailty (ie, “improvement”). Among four categories of frailty transitions, “worsening” and “remaining frail” had increased risks of painful death, eg, with odds ratios of 1.92 (95% confidence interval [CI] =1.41, 2.62) and 4.75 (95% CI =3.32, 6.80), respectively, for type 4 death (ie, ≥30 bedridden days with suffering before death). Conclusion This large sample of older adults in China supports that frailty is a dynamic process, characterized by frequent types of transitions. Furthermore, those who remained frail had the highest likelihood of experiencing painful death, which raises concerns about the quality of life in frail populations.