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在台湾北部社区中,老年虚弱的流行情况及其相关因素。

Prevalence and correlates of geriatric frailty in a northern Taiwan community.

机构信息

Division of Geriatric Research, Institute of Population Health Sciences, National Health Research Institutes, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

J Formos Med Assoc. 2011 Apr;110(4):247-57. doi: 10.1016/S0929-6646(11)60037-5.

Abstract

BACKGROUND/PURPOSE: Frailty is the core of geriatric syndromes in the elderly. However, there is no solid prevalence data in Taiwan even with the rapid growth of the elderly population. The aim of this study was to explore the prevalence of frailty defined by different instruments and to identify the factors associated with frailty in a northern Taiwan community.

METHODS

The 65-79-year old community-dwelling residents randomly selected from Toufen were first screened with a telephone version of the Chinese Canadian Study of Health and Aging Clinical Frailty Scale (CCSHA-CFS; level 1-7). Those who scored 3-6 with this instrument were evaluated at a local hospital with the Fried Frailty Index (FFI) and the Edmonton Frail Scale (EFS). Other baseline characteristics including health and functional performance were also evaluated.

RESULTS

Among the 2900 population representative samples, 845 (29.1%) completed the CCSHA-CFS telephone interview with the prevalence of frailty approximately 11.0% [95% confidence interval (CI) 8.9-13.1]. Among the 275 who completed assessments with FFI and EFS, prevalence of frailty was 11.3% (95% CI = 7.6-15.0) by FFI and 14.9% (95% CI = 10.7-19.1) by EFS. About 57.5% of respondents had memory impairment, 29.8% experienced pain, 25.1% experienced falls, 16.7% had depression, 14.5% had urinary incontinence, and 5.8% had polypharmacy. Being older, having more complaints with falls, pain, dysphagia, polypharmacy, depression, comorbidity, longer time for the Timed Up and Go test, less education, lower Mini-Mental State Examination score, and lower Barthel Index were associated with frailer status. In multinomial logistic regression analysis, increasing age, less education status, lower Barthel Index score and depression were positively associated with physical frailty.

CONCLUSION

In this study, the prevalence of frailty was from 11.0% to 14.9% by different criteria and methodology. Various correlates were independently associated with frailty status. It is suggested that intervention for frailty requires an interdisciplinary approach.

摘要

背景/目的:衰弱是老年人老年综合征的核心。然而,即使在老年人口快速增长的情况下,台湾也没有确凿的患病率数据。本研究旨在探讨不同工具定义的衰弱的患病率,并确定与台湾北部社区衰弱相关的因素。

方法

从头份随机选择 65-79 岁的社区居住居民,首先用电话版的加拿大华人健康老龄化研究临床衰弱量表(CCSHA-CFS;1-7 级)进行筛查。用这个工具评分 3-6 分的人在当地医院用弗雷德衰弱指数(FFI)和埃德蒙顿衰弱量表(EFS)进行评估。还评估了其他基线特征,包括健康和功能表现。

结果

在 2900 个有代表性的人群样本中,845 人(29.1%)完成了 CCSHA-CFS 电话访谈,衰弱的患病率约为 11.0%[95%置信区间(CI)为 8.9-13.1]。在 275 名完成 FFI 和 EFS 评估的患者中,FFI 评估的衰弱患病率为 11.3%(95%CI=7.6-15.0),EFS 评估的衰弱患病率为 14.9%(95%CI=10.7-19.1)。约 57.5%的受访者有记忆障碍,29.8%有疼痛,25.1%有跌倒,16.7%有抑郁,14.5%有尿失禁,5.8%有多种药物治疗。年龄较大、跌倒、疼痛、吞咽困难、多种药物治疗、抑郁、合并症、“计时起立行走”测试时间延长、受教育程度较低、简易精神状态检查评分较低和巴氏指数较低与衰弱状态相关。在多变量逻辑回归分析中,年龄增长、受教育程度较低、巴氏指数评分较低和抑郁与身体衰弱呈正相关。

结论

在这项研究中,不同标准和方法的衰弱患病率为 11.0%-14.9%。各种相关因素与衰弱状态独立相关。建议对衰弱进行干预需要采用多学科方法。

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