Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan.
Arch Gerontol Geriatr. 2012 Sep-Oct;55(2):385-91. doi: 10.1016/j.archger.2011.10.004. Epub 2011 Nov 17.
This study aimed to evaluate the physical frailty status of vulnerable older adults as classified in the Japanese LTCI system and to compare this with Fried's definition. A total of 444 older adults were classified based on the LTCI system as independent, vulnerable, or dependent, and 400 of these participants also fit Fried's criteria for not frail, pre-frail or frail. We evaluated their physical function with a 12 item physical function test. We derived a physical function score (PFS) from these 12 items and a principal component analysis was used to make comparisons. The receiver operating characteristic (ROC) curve analysis was performed to identify the sensitivity and specificity of the PFS cut-off points to distinguish the dependent category from the other categories. We found significant differences and a hierarchical order for the PFSs among the three groups of the LTCI system (the independent, 0.41 ± 0.54; the vulnerable, -0.40 ± 0.76; and the dependent, -1.49 ± 0.73) and of Fried's definition (not frail, 0.50 ± 0.51; pre frail, -0.11 ± 0.63; and frail, -1.25 ± 0.98). The optimal cut-off value (OCV) was -0.593. This study showed that the range of physical function of people considered frail category (pre-frail, vulnerable, and frail) is wide and overlapping. That is, the physical function of vulnerable older adults is worse than the pre-frail, but better than the frail. To better recognize older adults in need of greater support, the vulnerable should also receive assessment of their frailty status according to Fried's definition.
本研究旨在评估日本 LTCI 系统中脆弱老年人的身体虚弱状况，并将其与弗莱德的定义进行比较。共有 444 名老年人根据 LTCI 系统被分类为独立、脆弱或依赖，其中 400 名参与者也符合弗莱德的非虚弱、虚弱前期或虚弱标准。我们使用 12 项身体功能测试评估他们的身体功能。我们从这 12 项中得出一个身体功能评分（PFS），并使用主成分分析进行比较。进行了接收者操作特征（ROC）曲线分析，以确定 PFS 截断点区分依赖类别与其他类别的敏感性和特异性。我们发现 LTCI 系统（独立组，0.41 ± 0.54；脆弱组，-0.40 ± 0.76；依赖组，-1.49 ± 0.73）和弗莱德定义（非虚弱组，0.50 ± 0.51；虚弱前期组，-0.11 ± 0.63；虚弱组，-1.25 ± 0.98）三组间的 PFS 存在显著差异和层次顺序。最佳截断值（OCV）为-0.593。本研究表明，被认为属于虚弱类别的人群（虚弱前期、脆弱和虚弱）的身体功能范围较宽且重叠。也就是说，脆弱老年人的身体功能比虚弱前期差，但比虚弱好。为了更好地识别需要更多支持的老年人，脆弱的老年人也应根据弗莱德的定义评估其虚弱状况。
