Fatigue predicts mortality in older adults
Fatigue predicts mortality in older adults
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DOI：
10.1111/j.1532-5415.2008.01957.x
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发表时间：
2008-10-01
影响因子：
6.3
通讯作者：
Studenski, Stephanie A.
中科院分区：
文献类型：
--
作者：
Hardy, Susan E.;Studenski, Stephanie A.
目的：确定老年社区初级保健患者疲劳与10年以上生存率之间的关系。设计：前瞻性队列研究。单位：医疗保险健康维护组织和退伍军人事务初级保健项目。参与者：老年初级保健患者（N = 492）。测量方法：在基线时评估疲劳感，大部分时间被定义为感觉被解雇。死亡率根据国家死亡指数确定。协变量包括人口统计学、合并症、认知功能、抑郁症状、体重指数、自评健康、功能状态和步态速度。结果：有疲劳的老年人10年死亡率为59%(123/210)，无疲劳的老年人10年死亡率为38% (106/282)（P < .001）。在对多个潜在混杂因素进行调整后，基线时疲劳的参与者比不疲劳的参与者有更大的死亡风险（风险比= 1.44,95%置信区间= 1.08-1.93）。结论：一个简单的问题“你大部分时间都感到疲倦吗？”就能确定老年人的死亡率更高。需要进一步的研究来确定和描述疲劳的潜在机制，开发和测试特定的治疗方法，并确定改善是否会导致发病率和死亡率的降低。
OBJECTIVES: To determine the association between fatigue and survival over '10 years in a population of older community-dwelling primary care patients.DESIGN: Prospective cohort study.SETTING: Medicare health maintenance organization and Veterans Affairs primary care programs.PARTICIPANTS: Older primary care patients (N = 492).MEASUREMENTS: Fatigue, operationalized as feeling fired most of the time, was assessed at baseline. Mortality was ascertained from the National Death Index. Covariates included demographics, comorbidity, cognitive function, depressive symptoms, body mass index, self-rated health, functional Status, and gait speed.RESULTS: Mortality rates at 10 years were 59% (123/210) for older adults with fatigue, versus 38%, (106/282) for those without fatigue (P < .001). After adjustment for multiple potential confounders, participants who were tired at baseline had a greater risk of death than those who were not (hazard ratio = 1.44, 95% confidence interval = 1.08-1.93).CONCLUSION: A single simple question "Do you feel tired most of the time?" identifies older adults with a higher risk of mortality. Further research is needed to identify and characterize the underlying mechanisms of fatigue, to develop and test specific treatments, and to determine whether improvement leads to decreased morbidity and mortality.