Department of Family Medicine, National Taiwan University Hospital, Bei-Hu Branch Hospital. No. 37 Kangding Rd., Taipei City, Taiwan.
Arch Gerontol Geriatr. 2010 Feb;50 Suppl 1:S39-42. doi: 10.1016/S0167-4943(10)70011-X.
This randomized, controlled trial assessed the effectiveness of comprehensive geriatric assessment (CGA) and subsequent intervention in pre-frail and frail community-dwelling elderly based on the Fried Frailty Criteria (FFC) and the Barthel Index (BI) A total of 310 pre-frail or frail elderly from a single community were identified using the FFC. Of these, 152 were randomly assigned to the intervention group for CGA and appropriate intervention by medication adjustment, exercise instruction, nutrition support, physical rehabilitation, social worker consultation, and specialty referral. Clinical outcome was re-evaluated by the FFC and BI 6 months later. Compared to the control group, the intervention group tended to have a better outcome, with an odds ratio (OR) = 1.19, 95% confidence interval (95% CI) = 0.48-3.04, p = 0.71) and 3.29 (95% CI = 0.65-16.64, p = 0.15), respectively, and were less likely to deteriorate, with an OR = 0.78 (95% CI = 0.34-1.79, p = 0.57) and 0.94 (95% CI = 0.42-2.12, p = 0.88), respectively. Although no significant differences were observed, the CGA and subsequent intervention showed a favorable outcome in frail and pre-frail elderly based on the frailty status and BI. Inability to complete the CGA and poor compliance with the intervention program appear to be the main reasons for unfavorable outcomes.
这项随机对照试验评估了基于 Fried 衰弱标准（FFC）和 Barthel 指数（BI）的综合老年评估（CGA）和随后干预对衰弱前期和衰弱期社区居住的老年人的有效性。使用 FFC 确定了来自单个社区的 310 名衰弱前期或衰弱期老年人。其中，152 人被随机分配到干预组进行 CGA 和适当的干预，包括药物调整、运动指导、营养支持、物理康复、社工咨询和专科转介。6 个月后，再次使用 FFC 和 BI 评估临床结果。与对照组相比，干预组的结局倾向于更好，优势比（OR）分别为 1.19（95%置信区间（95%CI）=0.48-3.04，p=0.71）和 3.29（95%CI=0.65-16.64，p=0.15），不太可能恶化，OR 分别为 0.78（95%CI=0.34-1.79，p=0.57）和 0.94（95%CI=0.42-2.12，p=0.88）。尽管没有观察到显著差异，但 CGA 和随后的干预显示在衰弱和衰弱前期老年人中根据衰弱状态和 BI 具有良好的结局。无法完成 CGA 和对干预计划的依从性差似乎是结局不佳的主要原因。
