Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil; Institute and Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, State of São Paulo, Brazil; Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, State of São Paulo, Brazil.
Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil.
J Am Med Dir Assoc. 2017 Apr 1;18(4):367.e11-367.e18. doi: 10.1016/j.jamda.2016.12.067. Epub 2017 Feb 14.
The aim of the present study was to (1) evaluate a geriatric outpatient sample with the FRAIL scale; (2) investigate the psychometric properties of the scale; and (3) characterize different associations of the subdimensions of the scale with demographic and clinical data.
Cross-sectional observational study.
Geriatric outpatient center a university-based hospital in São Paulo, Brazil.
A total of 811 men and women aged 60 years or older evaluated between March 2015 and September 2015.
A translated version of the FRAIL scale was used to evaluate frailty. A review of sociodemographic data, medical records, medication, and laboratory data was conducted. A multivariate ordinal logistic regression model was used to investigate the association between frailty categories and clinical variables. Exploratory factor analysis and 2-parameter logistic item response theory was used to evaluate the psychometric properties of the FRAIL scale.
The sample was distributed as 13.6% robust, 48.7% prefrail, and 37.7% frail older adults. Most participants reported fatigue (72.3%). Frailty was associated with older age (P = .02), depression (P = .02), dementia (P < .001), and number of medications taken (P < .001). A 2-factor model of the FRAIL scale ("ambulation" and "resistance" namely physical performance; "fatigue," "weight loss," and "illnesses" namely health status) provided independent classifications of frailty status. Physical performance (ambulation and resistance) was strongly associated with higher age and dementia, whereas health status (fatigue, weight loss, and illnesses) was more associated with female sex and depression.
Our results suggest the existence of 2 subdimensions of the scale, suggesting different pathways to frailty. Frailty was associated with older age, depression, dementia, and number of medications in this outpatient sample.
本研究旨在：（1）评估老年门诊患者的 FRAIL 量表；（2）研究量表的心理测量特性；（3）用该量表的子维度来描述与人口统计学和临床数据的不同关联。
横断面观察性研究。
巴西圣保罗市一所大学附属医院的老年门诊中心。
共评估了 2015 年 3 月至 9 月期间 811 名年龄在 60 岁或以上的男性和女性。
使用 FRAIL 量表的翻译版本评估虚弱。进行了社会人口统计学数据、病历、药物和实验室数据的回顾。使用多元有序逻辑回归模型研究虚弱类别与临床变量之间的关联。探索性因子分析和 2 参数逻辑项目反应理论用于评估 FRAIL 量表的心理测量特性。
样本分布为 13.6%的健壮、48.7%的衰弱前期和 37.7%的衰弱老年人。大多数参与者报告疲劳（72.3%）。虚弱与年龄较大（P=0.02）、抑郁（P=0.02）、痴呆（P<0.001）和服用的药物数量（P<0.001）有关。FRAIL 量表的 2 因素模型（“活动能力”和“抵抗力”即身体表现；“疲劳”、“体重减轻”和“疾病”即健康状况）提供了虚弱状态的独立分类。身体表现（活动能力和抵抗力）与年龄较大和痴呆密切相关，而健康状况（疲劳、体重减轻和疾病）与女性和抑郁的关系更为密切。
我们的结果表明，该量表存在 2 个子维度，表明虚弱有不同的发生途径。在这个门诊样本中，虚弱与年龄较大、抑郁、痴呆和服用的药物数量有关。
