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社区居住老年人自我报告的健康状况与衰弱之间的关联。

Association between Self-Reported Health Status and Frailty in Community-Dwelling Elderly.

作者信息

González-Pichardo A M, Navarrete-Reyes A P, Adame-Encarnación H, Aguilar-Navarro S, García-Lara J M A, Amieva H, Avila-Funes J A

机构信息

José Alberto Ávila-Funes. Department of Geriatrics. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga 15. CP 14000; Tlalpan, México, Distrito Federal. Phone: + 52 (55) 54 87 09 00, 5703. E-mail:

出版信息

J Frailty Aging. 2014;3(2):104-8. doi: 10.14283/jfa.2014.9.

Abstract

BACKGROUND

The phenotype of frailty proposed by Fried et al. has been related with increased vulnerability for the development of adverse health-related outcomes. However, this phenotype is not often used in daily clinical practice. On the other hand, poor self-reported health status (SRHS) has been associated with similar adverse health-related outcomes.

OBJECTIVES

To determine the association between poor SRHS and frailty.

DESIGN, SETTING AND PARTICIPANTS: Cross-sectional study of 927 community-dwelling elderly aged 70 and older, participating in the Mexican Study of Nutritional and Psychosocial Markers of Frailty.

MEASUREMENTS

SRHS was established by the question "How do you rate your health status in general?" Frailty was defined according to the phenotype proposed by Fried et al. The association between SRHS and frailty was determined through the construction of multinomial logistic regression models. Final analyses were adjusted by socio-demographic and health covariates, including depressive symptoms. Also, agreement between SRHS and the phenotype of frailty was explored.

RESULTS

Prevalence of frailty was 14.1%, and 4.4% of participants rated their health status as "poor". The unadjusted regression analyses demonstrated that fair and poor SRHS were significantly associated with prefrail and frail status. After adjustment for multiple covariates, the association remained statistically significant. However, in the final adjustment for depressive symptoms, only the association between poor SRHS and frail status continued to be statistically significant. Fair agreement between poor SRHS and frail status was also found.

CONCLUSION

Poor SRHS shares common correlates as well as health-related adverse outcomes with frailty syndrome, and remains associated with it even when possible confounders are taken into account. Therefore, poor SRHS could be further explored as an option for frailty syndrome screening.

摘要

背景

弗里德等人提出的虚弱表型与出现不良健康相关结局的易感性增加有关。然而,这种表型在日常临床实践中并不常用。另一方面,自我报告的健康状况不佳已与类似的不良健康相关结局相关联。

目的

确定自我报告的健康状况不佳与虚弱之间的关联。

设计、设置和参与者:对927名年龄在70岁及以上的社区居住老年人进行横断面研究,这些老年人参与了墨西哥虚弱的营养和心理社会标志物研究。

测量

自我报告的健康状况通过“你总体上如何评价自己的健康状况?”这一问题来确定。虚弱根据弗里德等人提出的表型来定义。通过构建多项逻辑回归模型来确定自我报告的健康状况与虚弱之间的关联。最终分析根据社会人口统计学和健康协变量进行了调整,包括抑郁症状。此外,还探讨了自我报告的健康状况与虚弱表型之间的一致性。

结果

虚弱的患病率为14.1%,4.4%的参与者将他们的健康状况评为“差”。未经调整的回归分析表明,自我报告的健康状况为“一般”和“差”与前期虚弱和虚弱状态显著相关。在对多个协变量进行调整后,这种关联仍然具有统计学意义。然而,在对抑郁症状进行最终调整后,只有自我报告的健康状况“差”与虚弱状态之间的关联仍然具有统计学意义。自我报告的健康状况“差”与虚弱状态之间也存在中等程度的一致性。

结论

自我报告的健康状况不佳与虚弱综合征有共同的关联因素以及与健康相关的不良结局,并且即使考虑了可能的混杂因素,它仍然与之相关。因此,自我报告的健康状况不佳可作为虚弱综合征筛查的一个选项进行进一步探索。

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