Center for Family Medicine Family Health Team, Kitchener, Ontario, Canada.
Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Geriatr Gerontol Int. 2017 Oct;17(10):1358-1377. doi: 10.1111/ggi.12955. Epub 2017 Apr 12.
Identification of frailty in the primary care setting could be improved with the availability of easily identifiable markers of frailty. The purpose of this article was to systematically review markers for frailty or risk tools that have been validated in the ambulatory care setting.
Medline, PubMed, CIHAHL and Embase databases were searched up to March 2016 for studies on frailty markers in community-dwelling individuals 65 years or older. Studies were included for review if they were carried out in primary care or outpatient settings, used a validated definition of frailty, compared two or more markers, and used randomized controlled trial, quasi-experimental or prospective cohort designs.
Of the 3405 titles screened, 12 were retained for review. All of the studies were prospective cohort designs. Studies most frequently assessed biological markers, such as immune, inflammation, endocrine biomarkers and metabolic syndrome markers. Not one specific marker was repeatedly identified as a definitive marker for frailty.
There is a lack of psychometrically sound and clinically useful frailty markers. There is a need for further research to identify highly sensitive, specific and accurate markers that are feasible to use in the context of busy primary care practice. Geriatr Gerontol Int 2017; 17: 1358-1377.
在初级保健环境中，可以通过使用易于识别的脆弱性标志物来改善脆弱性的识别。本文的目的是系统地回顾在门诊环境中经过验证的脆弱性或风险工具的标志物。
截至 2016 年 3 月，通过 Medline、PubMed、CIHAHL 和 Embase 数据库检索了关于社区居住的 65 岁及以上人群中脆弱性标志物的研究。如果研究在初级保健或门诊环境中进行，使用了经过验证的脆弱性定义，比较了两种或更多标志物，并使用了随机对照试验、准实验或前瞻性队列设计，则纳入研究进行综述。
在筛选出的 3405 篇标题中，有 12 篇被保留用于综述。所有研究均为前瞻性队列设计。研究最常评估生物标志物，如免疫、炎症、内分泌生物标志物和代谢综合征标志物。没有一个特定的标志物被反复确定为脆弱性的明确标志物。
目前缺乏具有良好心理测量学特性和临床实用性的脆弱性标志物。需要进一步研究以确定高度敏感、特异和准确的标志物，这些标志物在繁忙的初级保健实践中是可行的。老年医学杂志 2017；17:1358-1377。
