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/.418
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发表时间：
2006-02-27
影响因子：
--
通讯作者：
Han, L
中科院分区：
文献类型：
--
作者：
Gill, TM;Gahbauer, EA;Han, L
背景：人们对虚弱的自然过程知之甚少。我们进行了一项前瞻性研究，以确定脆弱状态之间的转换率，并评估先前脆弱状态对后续脆弱转换的影响。方法：我们研究了754名70岁或以上的社区生活人员，他们在4项基本日常生活活动中没有残疾。每18个月评估一次，共54个月，根据体重减轻、精疲力竭、体力活动不足、肌肉无力和步行速度慢来定义虚弱。结果：在754名参与者中，434人(57.6%)在54个月内至少经历了3种脆弱状态中的一种转变。1次、2次和3次转变的发生率分别为36.8%、21.5%和9.2%。在18个月的间隔期间，向更脆弱状态的转变(比率高达43.3%)比向较不脆弱状态的转变(比率高达23.0%)更常见，从脆弱状态转变为非脆弱状态的可能性非常低(比率，0%-0.9%)，即使在较长的时期内也是如此。在脆弱状态之间转换的可能性高度依赖于一个人之前的脆弱状态。结论：老年人的脆弱是一个动态的过程，其特征是随着时间的推移在脆弱状态之间频繁转换。我们的发现为预防和补救脆弱提供了充足的机会。
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.