Transitions between frailty states among community-living older persons.
Transitions between frailty states among community-living older persons.
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DOI：
10.1001/archinte.166.4.418
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发表时间：
2006-02
影响因子：
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通讯作者：
T. Gill;E. Gahbauer;H. Allore;L. Han
中科院分区：
文献类型：
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作者：
T. Gill;E. Gahbauer;H. Allore;L. Han
背景技术人们对衰弱的自然过程知之甚少。我们进行了一项前瞻性研究，以确定虚弱状态之间的转变率，并评估先前的虚弱状态对后续虚弱转变的影响。方法 我们研究了 754 名年龄在 70 岁或以上的社区居民，他们在 4 项基本日常生活活动方面均无残疾。虚弱在 54 个月内每 18 个月进行一次评估，根据体重减轻、疲惫、体力活动少、肌肉无力和步行速度缓慢来定义。如果参与者满足其中 3 个或更多标准，则被分类为虚弱；如果满足 1 或 2 个标准，则被分类为体弱前；如果不满足任何标准，则被分类为非虚弱。结果 在 754 名参与者中，434 名（57.6%）在 54 个月内至少有 1 次在 3 种虚弱状态中的任意 2 种之间发生过转变。 1、2 和 3 次转换的比率分别为 36.8%、21.5% 和 9.2%。在 18 个月的时间间隔内，向较严重虚弱状态的转变（比率高达 43.3%）比向较轻虚弱状态的转变（比率高达 23.0%）更常见，而且从虚弱转变为非虚弱的概率非常低（比率为 0%-0.9%），即使在较长一段时间内也是如此。虚弱状态之间转变的可能性很大程度上取决于一个人之前的虚弱状态。结论 老年人的衰弱是一个动态过程，其特点是随着时间的推移，衰弱状态之间频繁转变。我们的研究结果表明有充足的机会预防和治疗虚弱。
BACKGROUND Little is known about the natural course of frailty. We performed a prospective study to determine the transition rates between frailty states and to evaluate the effect of the preceding frailty state on subsequent frailty transitions. METHODS We studied 754 community-living persons, aged 70 years or older, who were nondisabled in 4 essential activities of daily living. Frailty, assessed every 18 months for 54 months, was defined on the basis of weight loss, exhaustion, low physical activity, muscle weakness, and slow walking speed. Participants were classified as frail if they met 3 or more of these criteria, as prefrail if they met 1 or 2 of the criteria, and as nonfrail if they met none of the criteria. RESULTS Of the 754 participants, 434 (57.6%) had at least 1 transition between any 2 of the 3 frailty states during 54 months. The rates were 36.8%, 21.5%, and 9.2% for 1, 2, and 3 transitions, respectively. During the 18-month intervals, transitions to states of greater frailty were more common (rates up to 43.3%) than transitions to states of lesser frailty (rates up to 23.0%), and the probability of transitioning from being frail to nonfrail was very low (rates, 0%-0.9%), even during an extended period. The likelihood of transitioning between frailty states was highly dependent on one's preceding frailty state. CONCLUSIONS Frailty among older persons is a dynamic process, characterized by frequent transitions between frailty states over time. Our findings suggest ample opportunity for the prevention and remediation of frailty.