U.S. National Profile of Older Adults with Cognitive Impairment Alone, Physical Frailty Alone, and Both.
U.S. National Profile of Older Adults with Cognitive Impairment Alone, Physical Frailty Alone, and Both.
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DOI：
10.1111/jgs.16769
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发表时间：
2020-12
影响因子：
6.3
通讯作者：
Xue QL
中科院分区：
文献类型：
--
作者：
Ge ML;Carlson MC;Bandeen-Roche K;Chu NM;Tian J;Kasper JD;Xue QL
获得美国老年人中存在或不存在认知功能障碍的虚弱患病率的国家和地区估计值，以及存在或不存在虚弱的认知功能障碍患病率的国家和地区估计值，并确定区分其联合与单独发生的特征概况。横截面。社区或非疗养院的住宿护理设置。美国国家健康和老龄化趋势研究的7，497名65岁及以上老年人的全国代表性样本。虚弱是通过身体虚弱表型来衡量的。通过执行功能和记忆的认知表现测试或代理报告评估认知障碍。使用多项逻辑回归来确定人口统计学、社会经济学、健康、行为和心理社会特征的概况，这些特征区分四个亚组：不虚弱和认知完整（“两者都不”）、不虚弱和认知受损（“Cog.仅”）、虚弱且认知完整（“仅虚弱”）和虚弱且认知受损（“两者”）。“Cog.”的流行。仅”、“仅虚弱”和“两者都有”分别为25.5%、5.6%和8.7%。“仅虚弱”的个体肥胖、吸烟、合并症、肺部疾病和手术史的患病率最高。“两者都有”组的痴呆、抑郁、心血管疾病和残疾患病率最高。没有显着差异，发现之间的“齿轮。在手术史和合并症负担方面，“仅”组和“均不”组差异有统计学意义。老年痴呆症的患病率在“齿轮。只有”是不到一半的“两个”组。发现相当大的亚组有身体虚弱，但没有认知障碍，反之亦然，表明这两个不一定被认为是前因或后遗症。该研究提供了经验数据，支持在正式诊断评估之前，在虚弱和认知障碍的临床筛查中优先考虑合并症、肥胖、手术史和吸烟状况。
To obtain national and regional estimates of prevalence of frailty with or without cognitive impairment, and cognitive impairment with or without frailty among older adults in the US and identify profiles of characteristics that distinguish their joint vs. separate occurrence. Cross-sectional. Community or non-nursing home residential care settings. A US nationally-representative sample of 7,497 older adults aged 65 and older from the National Health and Aging Trends Study. Frailty was measured by the physical frailty phenotype. Cognitive impairment was assessed by cognitive performance testing of executive function and memory or by proxy-reports. Multinomial logistic regression was used to identify profiles of demographic, socioeconomic, health, behavioral, and psychosocial characteristics that distinguish four subgroups: not-frail and cognitively intact (“neither”), not-frail and cognitively impaired (“Cog. only”), frail and cognitively intact (“frailty only”), and frail and cognitively impaired (“both”). The prevalence of “Cog. only”, “frailty only”, and “both” was 25.5%, 5.6%, and 8.7%, respectively. Individuals with“frailty only” had the highest prevalence of obesity, current smoking, comorbidity, lung disease, and history of surgery. The “both” group had the highest prevalence of dementia, depression, cardiovascular diseases, and disability. No significant differences were found between the “Cog. only” group and the “neither” group with respect to history of surgery and comorbidity burden. The prevalence of dementia in the “Cog. only” was less than half of that in the “both” group. The finding of sizeable subgroups having physical frailty but not cognitive impairment, and vice versa, suggests that the two cannot be considered necessarily as antecedent or sequela of one another. The study provided empirical data supporting the prioritization of comorbidity, obesity, surgery history, and smoking status in clinical screening of frailty and cognitive impairment before formal diagnostic assessments.
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