Kwan Joseph Shiu Kwong, Lau Bobo Hi Po, Cheung Karen Siu Lan
Department of Medicine, The University of Hong Kong, Hong Kong, China.
Department of Psychology, The University of Hong Kong, Hong Kong, China.
J Am Med Dir Assoc. 2015 Jun 1;16(6):536.e1-7. doi: 10.1016/j.jamda.2015.03.005. Epub 2015 Apr 7.
A better understanding of the essential components of frailty is important for future developments of management strategies. We aimed to assess the incremental validity of a Comprehensive Model of Frailty (CMF) over Frailty Index (FI) in predicting self-rated health and functional dependency amongst near-centenarians and centenarians.
Cross-sectional, community-based study.
Two community-based social and clinical networks.
One hundred twenty-four community-dwelling Chinese near-centenarians and centenarians.
Frailty was first assessed using a 32-item FI (FI-32). Then, a new CMF was constructed by adding 12 items in the psychological, social/family, environmental, and economic domains to the FI-32. Hierarchical multiple regressions explored whether the new CMF provided significant additional predictive power for self-rated health and instrumental activities of daily living (IADL) dependency.
Mean age was 97.7 (standard deviation 2.3) years, with a range from 95 to 108, and 74.2% were female. Overall, 16% of our participants were nonfrail, 59% were prefrail, and 25% were frail. Frailty according to FI-32 significantly predicted self-rated health and IADL dependency beyond the effect of age and gender. Inclusion of the new CMF into the regression models provided significant additional predictive power beyond FI-32 on self-rated health, but not IADL dependency.
A CMF should ideally be a multidimensional and multidisciplinary construct including physical, cognitive, functional, psychosocial/family, environmental, and economic factors.
更好地理解衰弱的基本组成部分对于未来管理策略的发展至关重要。我们旨在评估综合衰弱模型（CMF）相对于衰弱指数（FI）在预测接近百岁老人和百岁老人的自评健康状况和功能依赖方面的增量效度。
基于社区的横断面研究。
两个基于社区的社会和临床网络。
124名居住在社区的中国接近百岁老人和百岁老人。
首先使用32项衰弱指数（FI-32）评估衰弱状况。然后，通过在FI-32的基础上增加心理、社会/家庭、环境和经济领域的12个项目构建了一个新的CMF。分层多元回归探讨了新的CMF是否为自评健康状况和日常生活工具性活动（IADL）依赖提供了显著的额外预测能力。
平均年龄为97.7（标准差2.3）岁，范围从95岁到108岁，74.2%为女性。总体而言，16%的参与者无衰弱，59%为衰弱前期，25%为衰弱。根据FI-32评估的衰弱状况在年龄和性别的影响之外，显著预测了自评健康状况和IADL依赖。将新的CMF纳入回归模型后，在自评健康状况方面，相对于FI-32提供了显著的额外预测能力，但在IADL依赖方面则没有。
理想情况下，CMF应该是一个多维和多学科的结构，包括身体、认知、功能、心理社会/家庭、环境和经济因素。
