Theou O, O'Connell M D L, King-Kallimanis B L, O'Halloran A M, Rockwood K, Kenny R A
Dalhousie University, Geriatric Medicine, Veterans' Memorial Building, 5955 Veterans' Memorial Lane, Halifax, Nova Scotia B3H2E1, Canada.
The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, Trinity College, Dublin 2, Ireland.
Age Ageing. 2015 May;44(3):471-7. doi: 10.1093/ageing/afv010. Epub 2015 Feb 16.
previously, frailty indices were constructed using mostly subjective health measures. The reporting error in this type of measure can have implications on the robustness of frailty findings.
to examine whether frailty assessment differs when we construct frailty indices using solely self-reported or test-based health measures.
secondary analysis of data from The Irish LongituDinal study on Ageing (TILDA).
4,961 Irish residents (mean age: 61.9 ± 8.4; 54.2% women) over the age of 50 years who underwent a health assessment were included in this analysis. We constructed three frailty indices using 33 self-reported health measures (SRFI), 33 test-based health measures (TBFI) and all 66 measures combined (CFI). The 2-year follow-up outcomes examined were all-cause mortality, disability, hospitalisation and falls.
all three indices had a right-skewed distribution, an upper limit to frailty, a non-linear increase with age, and had a dose-response relationship with adverse outcomes. Levels of frailty were lower when self-reported items were used (SRFI: 0.12 ± 0.09; TBFI: 0.17 ± 0.15; CFI: 0.14 ± 0.13). Men had slightly higher frailty index scores than women when test-based measures were used (men: 0.17 ± 0.09; women: 0.16 ± 0.10). CFI had the strongest prediction for risk of adverse outcomes (ROC: 0.64-0.81), and age was not a significant predictor when it was included in the regression model.
except for sex differences, characteristics of frailty are similar regardless of whether self-reported or test-based measures are used exclusively to construct a frailty index. Where available, self-reported and test-based measures should be combined when trying to identify levels of frailty.
以往，衰弱指数大多是使用主观健康指标构建的。这类指标中的报告误差可能会影响衰弱研究结果的稳健性。
探讨当我们仅使用自我报告的健康指标或基于检测的健康指标构建衰弱指数时，衰弱评估是否存在差异。
对爱尔兰纵向老龄化研究（TILDA）的数据进行二次分析。
本分析纳入了4961名年龄在50岁以上接受健康评估的爱尔兰居民（平均年龄：61.9±8.4岁；54.2%为女性）。我们使用33项自我报告的健康指标（SRFI）、33项基于检测的健康指标（TBFI）以及所有66项指标组合构建了三个衰弱指数（CFI）。所考察的2年随访结局包括全因死亡率、残疾、住院和跌倒。
所有三个指数均呈右偏分布，存在衰弱上限，随年龄呈非线性增加，且与不良结局存在剂量反应关系。使用自我报告项目时衰弱水平较低（SRFI：0.12±0.09；TBFI：0.17±0.15；CFI：0.14±0.13）。当使用基于检测的指标时，男性的衰弱指数得分略高于女性（男性：0.17±0.09；女性：0.16±0.10）。CFI对不良结局风险的预测最强（ROC：0.64 - 0.81），且在回归模型中纳入年龄时，年龄并非显著预测因素。
除性别差异外, 无论单独使用自我报告指标还是基于检测的指标构建衰弱指数，衰弱特征相似。在可行的情况下，尝试确定衰弱水平时应将自我报告指标和基于检测的指标结合使用。
