Blodgett Joanna, Theou Olga, Kirkland Susan, Andreou Pantelis, Rockwood Kenneth
Department of Community Health and Epidemiology, Dalhousie University, Centre for Clinical Research, 5790 University Avenue, Halifax, Nova Scotia, Canada B3H 1V7.
Geriatric Medicine, Department of Medicine, Dalhousie University, Veterans' Memorial Building, 5955 Veterans' Memorial Lane, Halifax, Nova Scotia, Canada.
Arch Gerontol Geriatr. 2015 May-Jun;60(3):464-70. doi: 10.1016/j.archger.2015.01.016. Epub 2015 Feb 3.
The two most commonly employed frailty measures are the frailty phenotype and the frailty index. We compared them to examine whether they demonstrated common characteristics of frailty scales, and to examine their association with adverse health measures including disability, self-reported health, and healthcare utilization. The study examined adults aged 50+ (n=4096) from a sequential, cross-sectional sample (2003-2004; 2005-2006), National Health and Nutrition Examination Survey. The frailty phenotype was modified from a previously adapted version and a 46-item frailty index was created following a standard protocol. Both measures demonstrated a right-skewed distribution, higher levels of frailty in women, exponential increase with age and associations with high healthcare utilization and poor self-reported health. More people classified as frail by the modified phenotype had ADL disability (97.8%) compared with the frailty index (56.6%) and similarly for IADL disability (95% vs. 85.6%). The prevalence of frailty was 3.6% using the modified frailty phenotype and 34% using the frailty index. Frailty index scores in those who were classified as robust by the modified phenotype were still significantly associated with poor self-reported health and high healthcare utilization. The frailty index and the modified frailty phenotype each confirmed previously established characteristics of frailty scales. The agreement between frailty and disability was high with each measure, suggesting that frailty is not simply a pre-disability stage. Overall, the frailty index classified more people as frail, and suggested that it may have the ability to discriminate better at the lower to middle end of the frailty continuum.
两种最常用的衰弱测量方法是衰弱表型和衰弱指数。我们对它们进行比较,以检查它们是否表现出衰弱量表的共同特征,并检查它们与包括残疾、自我报告的健康状况和医疗保健利用在内的不良健康指标之间的关联。该研究调查了来自2003 - 2004年和2005 - 2006年连续横断面样本(全国健康和营养检查调查)中50岁及以上的成年人(n = 4096)。衰弱表型是从先前改编的版本修改而来的,并按照标准方案创建了一个包含46个条目的衰弱指数。两种测量方法均显示出右偏分布,女性的衰弱水平更高,随年龄呈指数增长,并且与高医疗保健利用率和自我报告的健康状况不佳相关。与衰弱指数(56.6%)相比,更多被修改后的表型分类为衰弱的人存在日常生活活动(ADL)残疾(97.8%),对于工具性日常生活活动(IADL)残疾情况类似(95%对85.6%)。使用修改后的衰弱表型,衰弱患病率为3.6%,使用衰弱指数时为34%。在被修改后的表型分类为健康的人群中,衰弱指数得分仍与自我报告的健康状况不佳和高医疗保健利用率显著相关。衰弱指数和修改后的衰弱表型各自都证实了先前确立的衰弱量表特征。每种测量方法中,衰弱与残疾之间的一致性都很高,这表明衰弱不仅仅是残疾前阶段。总体而言,衰弱指数将更多人分类为衰弱,并表明它可能在衰弱连续体的中低端具有更好的区分能力。
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