Li Chia-Ming, Chang Ching-I, Yu Wen-Ruey, Yang Winnie, Hsu Chih-Cheng, Chen Ching-Yu
Department of Family Medicine, National Taiwan University Hospital, Bei-Hu Branch, Taiwan.
Division of Geriatrics and Gerontology, Institute of Population Health Sciences, National Health Research Institutes, Taiwan.
Arch Gerontol Geriatr. 2017 May-Jun;70:38-43. doi: 10.1016/j.archger.2016.12.009. Epub 2016 Dec 24.
This study aimed to assess the benefit of adding physical function evaluations and interventions to routine elderly health examination. This is a Quasi-experimental controlled trial. 404 elderly adults (aged 70 and over) scoring 3-6 on the Canadian Study of Health and Aging Clinical Frailty Scale Chinese In-Person Interview Version (CSHA-CFS) in a 2012 annual elderly health examination were enrolled. Both the control and experimental groups received the routine annual health examination with the latter further provided with functional evaluations, exercise instruction, and nutrition education. 112 (84.8%) persons in the experiment group and 267 (98.2%) in the control group completed the study. CSHA-CFS performance of the experimental group was more likely to improve (odds ratio=9.50, 95% confidence interval (CI)=4.62-19.56) and less likely to deteriorate (OR=0.04, 95% CI=0.01-0.31) one year after intervention. Within the experimental group, Fried Frailty Index improvement percentage surpassed the deterioration percentage (29.5% vs. 0.9%, p<0.001), five-meter walk speed rose from 1.0±0.2 to 1.2±0.2m/s (p<0.001), grip strength escalated from 22.3±7.1 to 24.8±6.7kg (p<0.001), Short-form Physical Performance Battery increased from 10.0±1.6 to 11.6±0.9 (p<0.001), and timed up and go test decreased from 10.9±2.9 to 8.9±2.7s (p<0.001). However, no statistical difference was detected in composite adverse endpoints, including hospitalization, emergency department visit and falls, between the two groups, though the incidence was higher in the control group. Adding functional evaluations, exercise and nutrition interventions to the annual elderly health examination appeared to benefit the health of adults aged 70 years and older.
本研究旨在评估在老年人常规健康检查中增加身体功能评估和干预措施的益处。这是一项准实验性对照试验。纳入了404名年龄在70岁及以上的老年人,他们在2012年的年度老年人健康检查中,加拿大健康与老龄化临床衰弱量表中文版(CSHA-CFS)的面对面访谈版本得分在3至6分之间。对照组和实验组都接受了常规年度健康检查,实验组还进一步接受了功能评估、运动指导和营养教育。实验组有112人(84.8%)、对照组有267人(98.2%)完成了研究。干预一年后,实验组的CSHA-CFS表现更有可能改善(优势比=9.50,95%置信区间(CI)=4.62-19.56)且更不可能恶化(OR=0.04,95%CI=0.01-0.31)。在实验组中,弗里德衰弱指数改善百分比超过恶化百分比(29.5%对0.9%,p<0.001),五米步行速度从1.0±0.2提高到1.2±0.2米/秒(p<0.001),握力从22.3±7.1提高到24.8±6.7千克(p<0.001),简短身体性能量表从10.0±1.6提高到11.6±0.9(p<0.001),计时起立行走测试从10.9±2.9减少到8.9±2.7秒(p<0.001)。然而,两组在包括住院、急诊就诊和跌倒在内的复合不良终点方面未检测到统计学差异,尽管对照组的发生率更高。在年度老年人健康检查中增加功能评估、运动和营养干预似乎有益于70岁及以上成年人的健康。