A pilot trial to predict frailty syndrome: The Japanese Health Research Volunteer Study
A pilot trial to predict frailty syndrome: The Japanese Health Research Volunteer Study
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DOI：
10.1016/j.exger.2012.05.016
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发表时间：
2012-08-01
影响因子：
3.9
通讯作者：
Hinohara, Shigeaki
中科院分区：
文献类型：
--
作者：
Doba, Nobutaka;Tokuda, Yasuharu;Hinohara, Shigeaki
大多数关于脆弱的定义都是基于美国人口的发展。脆弱的概念在日本还没有得到很好的研究，日本是世界上老年患者（人均）比例最高的国家。我们对居住在社区的日本老年人进行了一项为期5年的前瞻性队列研究。根据我们对加拿大健康与老龄化临床虚弱量表的定义，参与者在基线时并不虚弱。参与者在基线时进行了全面的老年评估（CGA），最终评估通过亲自或邮寄调查进行。我们招募了407人（男性184人，平均年龄78±4岁；女性223人，平均年龄77±4岁）。到研究结束时，65名参与者符合虚弱的标准。在单变量分析中，18个单独的参数与虚弱相关，其中一些包括：年龄、性别、握力、计时行走、收缩压、脉压、认知状态、独居和听力缺陷。在多变量分析中，以下因素仍然与虚弱相关：定时行走、脉压、认知缺陷和听力缺陷。我们建立了计时行走（5米/3秒）和脉压（60毫米汞柱）的分界点。然后，我们为这四个因素创建了一个简单的相加得分（出席= 1；缺席= 0）。0分为93%的衰弱阴性预测值，而4分为70%的衰弱阳性预测值。虽然需要进一步的研究，但这项工作创造了一个易于管理的工具，可以推广到其他人群。(C) 2012爱思唯尔公司版权所有。
Most definitions of frailty utilize US populations in their development. The concept of frailty has not been well studied in Japan, which has the largest percentage of older patients ( per capita) in the world. We created a 5-year prospective cohort study of community-dwelling older Japanese adults. Participants were not frail at baseline, based on our definition adapted from the Canadian Study for Health and Aging Clinical Frailty Scale. Participants underwent a comprehensive geriatric assessment (CGA) at baseline, and final assessments were either in person or via mailed survey. We enrolled 407 individuals (184 men, mean age 78 +/- 4 years; 223 women, mean age 77 +/- 4 years). Sixty-five participants met criteria for frailty by the end of the study. In univariate analyses, eighteen separate parameters were associated with frailty, some of which included: age, gender, handgrip, timed walk, systolic blood pressure, pulse pressure, cognitive status, living alone, and hearing deficits. In multivariate analyses, the following elements remained associated with frailty: timed walk, pulse pressure, cognition deficits and hearing deficits. We established cut-off points for timed walk (5 m/3 s) and pulse pressure (60 mm Hg). We then created a simple additive score for these four factors (present = 1; absent = 0). A score of 0 had a 93% negative predictive value for frailty while a score of 4 had a 70% positive predictive value. While further study is needed, this work creates an easy-to-administer tool that may be generalizable to other populations. (C) 2012 Elsevier Inc. All rights reserved.