Department of Internal Medicine, Geriatric Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Pace 9, 20122 Milan, Italy.
Aging Ment Health. 2010 Nov;14(8):1024-36. doi: 10.1080/13607863.2010.508772.
To determine the main social, functional and clinical characteristics of community-dwelling older outpatients living alone and to find correlates of frailty in this population.
Cross-sectional survey of 302 community-dwelling outpatients aged 65+ (median age 82 years) consecutively referred to a geriatric medicine clinic in Italy from June to November 2009. Participants underwent a comprehensive geriatric assessment including frailty status evaluated by means of the study of osteoporotic fractures (SOF) criteria. Student's t-test and the chi-squared test were used to compare subjects 'living alone' and 'not living alone' as well as 'frail' and 'not frail' subjects among the participants living alone. Multiple logistic regression analyses were performed to find independent correlates of frailty among participants living alone.
Participants 'living alone' were 124 (41%). Compared to subjects 'not living alone' (n = 178), they were older, received less assistance from informal and formal caregivers, had poorer living and financial conditions, a better cognitive status and functional self-sufficiency but a worse emotional status. One-third of them (n = 41) were frail. Among frail elders (n = 116), subjects living alone also showed a higher prevalence of unexpected new diagnoses of dementia than those not living alone. Independent correlates of frailty among participants living alone were: having experienced a severe acute disease in the past year (odds ratio [OR] 303.9; 95% confidence interval [CI] 13-7091; p < 0.001), dependence in the bathing BADL ability (OR 62.74; 95% CI 12.17-323.32; p < 0.001), depression (OR 10.43; 95% CI 2.31-47.13; p = 0.002) and incontinence (OR 3.98; 95% CI 1.01-15.66; p = 0.048).
In older outpatients living alone, including those who were frail, we found a lower availability of personal assistance, significantly more social and financial vulnerability and a higher risk of depression. In frail elders there was also a higher prevalence of underdiagnosed dementia. In order to better recognise frail subjects in this specific population, four independent correlates of frailty were identified.
确定独居的社区老年门诊患者的主要社会、功能和临床特征，并找出该人群衰弱的相关因素。
这是一项 2009 年 6 月至 11 月间在意大利一家老年医学诊所连续就诊的 302 名 65 岁以上（中位年龄 82 岁）的社区门诊患者的横断面调查。参与者接受了全面的老年评估，包括使用骨质疏松性骨折研究（SOF）标准评估的衰弱状况。采用学生 t 检验和卡方检验比较了独居者和非独居者、独居者中的衰弱者和非衰弱者之间的差异。采用多因素逻辑回归分析确定独居者中衰弱的独立相关因素。
参与者中独居者为 124 人（41%）。与非独居者（n=178）相比，独居者年龄更大，从非正式和正式照顾者那里获得的帮助较少，生活和经济条件较差，认知状态和功能自理能力较好，但情绪状态较差。其中三分之一（n=41）为衰弱。在衰弱的老年人（n=116）中，独居者中意外新诊断痴呆的比例也高于非独居者。独居者中衰弱的独立相关因素为：过去一年经历过严重急性疾病（优势比[OR]303.9；95%置信区间[CI]13-7091；p<0.001）、洗澡日常生活活动能力（BADL）依赖（OR 62.74；95% CI 12.17-323.32；p<0.001）、抑郁（OR 10.43；95% CI 2.31-47.13；p=0.002）和尿失禁（OR 3.98；95% CI 1.01-15.66；p=0.048）。
在独居的老年门诊患者中，包括那些衰弱的患者，我们发现个人援助的可用性较低，社会和经济脆弱性显著增加，抑郁风险增加。在衰弱的老年人中，未被诊断出的痴呆症的患病率也更高。为了更好地识别这一特定人群中的衰弱患者，我们确定了四个衰弱的独立相关因素。
