Bandeen-Roche Karen, Xue Qian-Li, Ferrucci Luigi, Walston Jeremy, Guralnik Jack M, Chaves Paulo, Zeger Scott L, Fried Linda P
Department of Biostatistics, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
J Gerontol A Biol Sci Med Sci. 2006 Mar;61(3):262-6. doi: 10.1093/gerona/61.3.262.
"Frailty" is an adverse, primarily gerontologic, health condition regarded as frequent with aging and having severe consequences. Although clinicians claim that the extremes of frailty can be easily recognized, a standardized definition of frailty has proved elusive until recently. This article evaluates the cross-validity, criterion validity, and internal validity in the Women's Health and Aging Studies (WHAS) of a discrete measure of frailty recently validated in the Cardiovascular Health Study (CHS).
The frailty measure developed in CHS was delineated in the WHAS data sets. Using latent class analysis, we evaluated whether criteria composing the measure aggregate into a syndrome. We verified the criterion validity of the measure by testing whether participants defined as frail were more likely than others to develop adverse geriatric outcomes or to die.
The distributions of frailty in the WHAS and CHS were comparable. In latent class analyses, the measures demonstrated strong internal validity vis à vis stated theory characterizing frailty as a medical syndrome. In proportional hazards models, frail women had a higher risk of developing activities of daily living (ADL) and/or instrumental ADL disability, institutionalization, and death, independently of multiple potentially confounding factors.
The findings of this study are consistent with the widely held theory that conceptualizes frailty as a syndrome. The frailty definition developed in the CHS is applicable across diverse population samples and identifies a profile of high risk of multiple adverse outcomes.
“衰弱”是一种主要在老年人群中出现的不良健康状况，随着年龄增长而常见且后果严重。尽管临床医生声称极端的衰弱情况很容易识别，但直到最近，衰弱的标准化定义仍难以确定。本文评估了在心血管健康研究（CHS）中最近得到验证的一种衰弱离散测量方法在女性健康与衰老研究（WHAS）中的交叉效度、标准效度和内部效度。
在WHAS数据集中描述了CHS中开发的衰弱测量方法。使用潜在类别分析，我们评估了构成该测量方法的标准是否汇总为一种综合征。我们通过测试被定义为衰弱的参与者是否比其他人更有可能出现不良老年结局或死亡来验证该测量方法的标准效度。
WHAS和CHS中衰弱的分布具有可比性。在潜在类别分析中，相对于将衰弱描述为一种医学综合征的既定理论，这些测量方法显示出很强的内部效度。在比例风险模型中，衰弱女性独立于多种潜在混杂因素，发生日常生活活动（ADL）和/或工具性ADL残疾、入住机构和死亡的风险更高。
本研究结果与将衰弱概念化为一种综合征的广泛理论一致。CHS中开发的衰弱定义适用于不同的人群样本，并识别出多种不良结局的高风险特征。
