Aguilar-Navarro S, Gutiérrez-Robledo L M, García-Lara J M A, Payette H, Amieva H, Avila-Funes J A
José Alberto Ávila-Funes. Department of Geriatrics. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga 15. CP 14000; Tlalpan, Distrito Federal, México. Phone: +52 (55) 54 87 09 00, 5703. E-mail:
J Frailty Aging. 2012;1(3):111-7. doi: 10.14283/jfa.2012.18.
Frailty represents a major public health priority in Western countries. Specific social and cultural factors may influence the prevalence and predictive value for negative health-related events of this syndrome.
To determine the prevalence and predictive value of the phenotype of frailty among community-dwelling Mexican American older persons.
DESIGN, SETTING AND PARTICIPANTS: Two-year longitudinal study of 5,644 men and women aged 60 years and older participating in the Mexican Health and Aging Study.
The Frailty index used in the present study was a modified version of the operational definition proposed in the Cardiovascular Health Study (CHS). Frailty was defined by the presence of at least three of the four following criteria: weight loss, weakness, exhaustion, slowness, and low physical activity. The main outcomes were incident disability and mortality. Chi-square, ANOVA and multiple logistic regression analyses were used to test the prognostic value of frailty for the outcomes of interest.
The mean age of the study sample was 68.7 (SD 6.9) years. Thirty-seven percent of participants (n=2,102) met the definition of frailty. Frail subjects were significantly older, and more likely to be women than non-frail participants. They also presented lower education, more chronic diseases, lower income, and poorer self-reported health status. After adjusting for potential confounders, frailty was found to be a predictor of incident mobility disability (odds ratio [OR] 1.91, 95% confidence interval [CI] 1.37-2.66), activities of daily living (ADL) disability (OR 9.33; 95%CI 3.37-25.82), and instrumental ADL (IADL) disability (OR 1.81, 95%CI 1.23-2.68). The risk of mortality among frail participants was almost three-fold higher than in non-frail ones.
The prevalence of frailty is higher in this elderly population than what previously reported in other cohorts. The phenotype of frailty was confirmed to be a predictor for adverse health-related outcomes (including mobility, ADL, and IADL disability). Further studies in Latin American countries are needed to identify frailty and develop adapted interventions for the prevention of adverse outcomes in older persons.
衰弱是西方国家主要的公共卫生优先事项。特定的社会和文化因素可能会影响该综合征在与健康相关的负面事件中的患病率和预测价值。
确定居住在社区的墨西哥裔美国老年人中衰弱表型的患病率和预测价值。
设计、地点和参与者：对5644名年龄在60岁及以上参与墨西哥健康与老龄化研究的男性和女性进行为期两年的纵向研究。
本研究中使用的衰弱指数是心血管健康研究（CHS）中提出的操作定义的修改版本。衰弱的定义为存在以下四项标准中的至少三项：体重减轻、虚弱、疲惫、行动迟缓以及身体活动量低。主要结局为新发残疾和死亡率。采用卡方检验、方差分析和多元逻辑回归分析来检验衰弱对感兴趣结局的预后价值。
研究样本的平均年龄为68.7（标准差6.9）岁。37%的参与者（n = 2102）符合衰弱的定义。与非衰弱参与者相比，衰弱的受试者年龄显著更大，且更可能为女性。他们的受教育程度也更低，患有更多慢性疾病，收入更低，自我报告的健康状况更差。在对潜在混杂因素进行调整后，发现衰弱是新发行动能力残疾（比值比[OR] 1.91，95%置信区间[CI] 1.37 - 2.66）、日常生活活动（ADL）残疾（OR 9.33；95%CI 3.37 - 25.82）以及工具性ADL（IADL）残疾（OR 1.81，95%CI 1.23 - 2.68）的预测因素。衰弱参与者的死亡风险几乎是非衰弱参与者的三倍。
该老年人群中衰弱的患病率高于先前其他队列报告的水平。衰弱表型被证实是与健康相关不良结局（包括行动能力、ADL和IADL残疾）的预测因素。需要在拉丁美洲国家开展进一步研究，以识别衰弱并制定适合的干预措施来预防老年人的不良结局。
