Tkacheva O N, Runikhina N K, Ostapenko V S, Sharashkina N V, Mkhitaryan E A, Onuchina U S, Lysenkov S N
Pirogov Russian National Research Medical University, Russian Gerontology Clinical Research Center, Moscow, 129226, Russian Federation.
Sechenov First Moscow State Medical University, Moscow, 119991, Russian Federation.
Adv Gerontol. 2017;30(2):236-242.
For screening frailty in daily practice, we developed the questionnaire relating issues of weight loss, impaired vision and hearing, injuries related to falls, mood decline, cognitive impairment, urinary incontinence, and mobility difficulties. 356 outpatients from Moscow were included in the study (mean age 74,9±6,1 years, women - 80,4 %). Patients were interviewed using the questionnaire and underwent a comprehensive geriatric assessment. The phenotype model of frailty was determined by L. Fried criteria, the frailty index model - by K. Rockwood criteria. ROC-analysis demonstrated a satisfactory agreement between the result of the survey by the questionnaire and assessment the phenotype model of frailty and the frailty index model (AUC=0,765 and 0,731, respectively). The results statistically significantly correlated with the assessment of the phenotype model of frailty and the frailty index model (Spearman correlation = 0,4 and 0,41, p<0,001). Optimal characteristics of the questionnaire for the frailty screening were consistent to cut-off ≥3 and ≥ 4 points. We propose to use a cut-off ≥ 3 point, since it corresponds to a higher value of sensitivity (85,7 and 93,3 % compared with the phenotype model of frailty and the frailty index model respectively). The proportion of patients who scored ≥ 3 points (58,4 %) indicates a high prevalence of geriatric syndromes among outpatients in Moscow.
为了在日常实践中筛查衰弱，我们编制了一份问卷，涉及体重减轻、视力和听力受损、跌倒相关损伤、情绪低落、认知障碍、尿失禁和行动困难等问题。该研究纳入了356名来自莫斯科的门诊患者（平均年龄74.9±6.1岁，女性占80.4%）。使用该问卷对患者进行访谈，并对其进行全面的老年综合评估。衰弱的表型模型根据L. Fried标准确定，衰弱指数模型根据K. Rockwood标准确定。ROC分析表明，问卷调查结果与衰弱表型模型及衰弱指数模型的评估结果之间具有良好的一致性（AUC分别为0.765和0.731）。结果与衰弱表型模型及衰弱指数模型的评估在统计学上具有显著相关性（Spearman相关性分别为0.4和0.41，p<0.001）。用于衰弱筛查的问卷的最佳特征是截断值≥3分和≥4分。我们建议使用截断值≥3分，因为它对应的敏感性更高（与衰弱表型模型和衰弱指数模型相比分别为85.7%和93.3%）。得分≥3分的患者比例（58.4%）表明莫斯科门诊患者中老年综合征的患病率很高。
