Bartley Mairead M, Geda Yonas E, Christianson Teresa J H, Pankratz V Shane, Roberts Rosebud O, Petersen Ronald C
Department of Neurology, Mayo Clinic, Rochester, Minnesota.
Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
J Am Geriatr Soc. 2016 Jan;64(1):132-7. doi: 10.1111/jgs.13821.
To characterize frailty in cognitively normal older adults at baseline and to investigate the relationship between frailty and mortality.
Population-based prospective cohort study: Mayo Clinic Study of Aging.
Olmsted County, Minnesota.
Cognitively normal older persons aged 70 and older (mean age 78.8±5.2, 50.2% male; N=2,356).
Frailty was assessed at baseline using a 36-item Frailty Index. Four frailty subgroups were identified based on the Frailty Index (≤0.10 (fit), 0.11-0.20 (at risk), 0.21-0.30 (frail), >0.30 (frailest)). All participants underwent comprehensive clinical and cognitive assessments. The association between frailty and mortality was assessed using Cox proportional hazards models.
The median Frailty Index was 0.17 (interquartile range 0.11-0.22). Frailty increased with age and was more common in older men than in older women. Over a median follow-up of 6.5 years (range 7 days to 8.9 years), 500 of the 2,356 participants died, including 292 men. The frailest participants had the greatest risk of death (hazard ratio (HR)=3.91, 95% confidence interval (CI)=2.69-5.68). The association was stronger in women (HR=5.26, 95% CI=2.88-9.61) than men (HR=3.15, 95% CI=1.98-5.02).
Baseline frailty was common, especially in older men, and increased with age. Frailty was associated with significantly greater risk of death, particularly in women. These sex differences should be considered when designing a geriatric care plan.
在基线时对认知正常的老年人的衰弱状况进行特征描述，并研究衰弱与死亡率之间的关系。
基于人群的前瞻性队列研究：梅奥诊所衰老研究。
明尼苏达州奥尔姆斯特德县。
70岁及以上认知正常的老年人（平均年龄78.8±5.2岁，男性占50.2%；N = 2356）。
在基线时使用36项衰弱指数评估衰弱状况。根据衰弱指数确定了四个衰弱亚组（≤0.10（健康），0.11 - 0.20（有风险），0.21 - 0.30（衰弱），>0.30（最衰弱））。所有参与者都接受了全面的临床和认知评估。使用Cox比例风险模型评估衰弱与死亡率之间的关联。
衰弱指数的中位数为0.17（四分位间距0.11 - 0.22）。衰弱随年龄增长而增加，在老年男性中比在老年女性中更常见。在中位随访6.5年（范围7天至8.9年）期间，2356名参与者中有500人死亡，其中包括292名男性。最衰弱的参与者死亡风险最高（风险比（HR）= 3.91，95%置信区间（CI）= 2.69 - 5.68）。这种关联在女性中（HR = 5.26，95% CI = 2.88 - 9.61）比在男性中（HR = 3.15，95% CI = 1.98 - 5.02）更强。
基线衰弱很常见，尤其是在老年男性中，且随年龄增长而增加。衰弱与显著更高的死亡风险相关，尤其是在女性中。在设计老年护理计划时应考虑这些性别差异。
