Associate Professor, Department of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taiwan.
J Nurs Scholarsh. 2014 May;46(3):207-15. doi: 10.1111/jnu.12068. Epub 2014 Feb 6.
This study explored the risk factors, cut-off points, sensitivity, specificity, positive predictive values, and negative predictive values of physical performance testing among community-dwelling frail elderly people in Taiwan.
The empirical measurement of frailty is based on the following five indicators: weight loss, weakness, exhaustion, slow responses, and minimal physical activity. The frail phenotype is considered present if three or more of the indicators are observed. Meanwhile, a short battery of physical performance tests was conducted to assess the balance, mobility, and flexibility among elderly people.
A cross-sectional research design was executed. Participants were evaluated using a short battery of physical performance tests to assess their physical performance. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed.
The logistic regression results showed that the factors significantly correlated to frailty included falls in the previous year, smoking, hypertension, and bone and joint disease. Physical performance test scores were analyzed using the ROC curves to discriminate frailty statuses. The analysis results showed that the areas under the ROC curves for the diagnostic accuracy of right-hand grip, left-hand grip, and the 8-foot up-and-go test reached 0.70, and the optimal cut-off points determined using Youden's index were 17.25 kg, 20.75 kg, and 8.13 s, respectively.
The research findings suggest that physical performance variables can be used to effectively screen elderly people at risk for frailty in the community.
The findings offer reference values for physical performance tests specific to community-dwelling frail elderly people. The information can enable health practitioners to achieve early identification of frailty among elderly people with anthropometric characteristics similar to those associated with people in Asian countries.
本研究旨在探讨台湾社区居住的虚弱老年人的身体表现测试的风险因素、截止值、灵敏度、特异性、阳性预测值和阴性预测值。
虚弱的经验测量基于以下五个指标:体重减轻、虚弱、疲惫、反应迟钝和最小体力活动。如果观察到三个或更多指标,则认为存在虚弱表型。同时,进行了一系列简短的身体表现测试,以评估老年人的平衡、移动性和灵活性。
采用横断面研究设计。使用简短的身体表现测试套件评估参与者的身体表现,对其进行评估。进行多元逻辑回归和接收器操作特征(ROC)分析。
逻辑回归结果表明,与虚弱显著相关的因素包括前一年的跌倒、吸烟、高血压和骨骼关节疾病。使用 ROC 曲线分析身体表现测试分数以区分虚弱状态。分析结果表明,右手握力、左手握力和 8 英尺起身测试的 ROC 曲线下面积的诊断准确性达到 0.70,使用约登指数确定的最佳截止点分别为 17.25 公斤、20.75 公斤和 8.13 秒。
研究结果表明,身体表现变量可用于有效筛选社区中处于虚弱风险的老年人。
研究结果为社区居住的虚弱老年人的身体表现测试提供了参考值。这些信息可以使健康从业者能够识别出与亚洲国家人群相关的人体测量特征相似的老年人的虚弱。