Buttery Amanda K, Busch Markus A, Gaertner Beate, Scheidt-Nave Christa, Fuchs Judith
Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 64, Berlin, 12101, Germany.
BMC Geriatr. 2015 Mar 8;15:22. doi: 10.1186/s12877-015-0022-3.
Despite having the third highest proportion of people aged 60 years and older in the world, Germany has been recently reported as having the lowest prevalence of frailty of 15 European countries. The objective of the study is to describe the prevalence of frailty in a large nationwide population-based sample and examine associations with sociodemographic, social support and health characteristics.
We performed a cross-sectional analysis of the first wave of the German Health Interview and Examination Survey for Adults (DEGS1) conducted 2008-2011. Participants were 1843 community-dwelling people aged 65-79 years. Frailty and pre-frailty were defined, according to modified Fried criteria, as 3 and more or 1-2 respectively, of the following: exhaustion, low weight, low physical activity, low walking speed and low grip strength. The Oslo-3 item Social Support Scale (OSS-3) was used. Patient Health Questionnaire (PHQ-9) measured depressive symptoms and the Digit Symbol Substitution Test (DSST) measured cognition. Associations between participants' characteristics and frailty status were examined using unadjusted and adjusted multinomial logistic regression models estimating relative risk ratios (RRR) of frailty and pre-frailty.
The prevalence of frailty among women was 2.8% (CI 1.8-4.3) and pre-frailty 40.4% (CI 36.3-44.7) and among men was 2.3% (CI 1.3-4.1) and 36.9% (CI 32.7-41.3) respectively. Independent determinants of frailty, from unadjusted models, included older age, low socioeconomic status, poor social support, lower cognitive function and a history of falls. In adjusted models current depressive symptoms (RRR 12.86, CI 4.47-37.03), polypharmacy (RRR 7.78, CI 2.92-20.72) and poor hearing (RRR 5.38, CI 2.17-13.35) were statistically significantly associated with frailty.
Frailty prevalence is relatively low among community-dwelling older adults in Germany. Modifiable characteristics like low physical activity provide relevant targets for individual and population-level frailty detection and intervention strategies.
尽管德国60岁及以上人口比例在世界上排名第三，但最近有报道称，在15个欧洲国家中，德国的衰弱患病率最低。本研究的目的是描述在一个基于全国大规模人群样本中的衰弱患病率，并研究其与社会人口统计学、社会支持和健康特征之间的关联。
我们对2008 - 2011年进行的德国成人健康访谈与检查调查（DEGS1）第一波数据进行了横断面分析。参与者为1843名年龄在65 - 79岁的社区居民。根据改良的弗里德标准，将衰弱和衰弱前期分别定义为出现以下情况中的3项及以上或1 - 2项：疲惫、体重过低、身体活动不足、步行速度慢和握力弱。使用了奥斯陆3项社会支持量表（OSS - 3）。患者健康问卷（PHQ - 9）用于测量抑郁症状，数字符号替换测验（DSST）用于测量认知能力。使用未调整和调整后的多项逻辑回归模型来估计衰弱和衰弱前期的相对风险比（RRR），以检验参与者特征与衰弱状态之间的关联。
女性中衰弱患病率为2.8%（95%置信区间1.8 - 4.3），衰弱前期患病率为40.4%（95%置信区间36.3 - 44.7）；男性中衰弱患病率为2.3%（95%置信区间1.3 - 4.1），衰弱前期患病率为36.9%（95%置信区间32.7 - 41.3）。在未调整模型中，衰弱的独立决定因素包括年龄较大、社会经济地位较低、社会支持差、认知功能较低以及有跌倒史。在调整模型中，当前的抑郁症状（RRR 12.86，95%置信区间4.47 - 37.03）、多重用药（RRR 7.78，95%置信区间2.92 - 20.72）和听力差（RRR 5.38，95%置信区间2.17 - 13.35）与衰弱在统计学上显著相关。
德国社区居住的老年人中衰弱患病率相对较低。像身体活动不足这样可改变的特征为个体和人群层面的衰弱检测及干预策略提供了相关目标。
