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老年人住院后衰弱状况及表型组成部分的变化。

Changes in frailty conditions and phenotype components in elderly after hospitalization.

作者信息

Marchiori Gianna Fiori, Tavares Darlene Mara Dos Santos

机构信息

Doctoral student, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.

PhD, Associate Professor, Instituto de Ciências da Saúde, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.

出版信息

Rev Lat Am Enfermagem. 2017 Jul 10;25:e2905. doi: 10.1590/1518-8345.1417.2905.

DOI:10.1590/1518-8345.1417.2905
PMID:28699992
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5510999/
Abstract

OBJECTIVE

: describing the changes in frailty conditions over the period of a year after hospital discharge, verifying predictive variables for changes in frailty conditions and frailty phenotype components according to worsening, improving and stable groups.

METHOD

: a longitudinal survey carried out with 129 elderly. A structured form for socioeconomic and health data, scales (Geriatric Depression Scale - short form, Katz scale, Lawton and Brody scale) and frailty phenotype according to Fried were used. Descriptive analysis and multinomial logistic regression model (p<0.05) were performed.

RESULTS

: we found that 56.7% of older adults changed their condition from non-frail to pre-frail, with no changes from non-frail to frail. Deaths were found between frail and pre-frail elderly. In the worsening group, the increase in the number of morbidities was a predictor for exhaustion and/or fatigue, while in the improving group, increased dependence on instrumental activities of daily living was a predictor for weight loss, and reduced scores indicative of depression due to low level of physical activity.

CONCLUSION

: a greater percentage of changes from non-frail condition to pre-frail older adults were observed, and health variables were only predictive for frailty phenotype components.

OBJETIVO

: descrever as mudanças nas condições de fragilidade ao longo de um ano após a alta hospitalar, e verificar as variáveis preditoras da mudança das condições de fragilidade e dos componentes do fenótipo de fragilidade, segundo grupos de piora, melhora e estabilidade.

MÉTODO:: inquérito longitudinal, realizado com 129 idosos. Utilizou-se formulário estruturado para dados socioeconômicos e saúde, escalas (Depressão Geriátrica Abreviada, Katz, Lawton e Brody) e fenótipo de fragilidade, segundo Fried. Procederam-se às análises descritiva e modelo de regressão logística multinomial (p<0,05).

RESULTADOS

: constatou-se que 56,7% dos idosos mudaram sua condição de não frágeis para pré-frágeis, não ocorrendo mudança dos não frágeis para frágeis. Observou-se o óbito entre idosos frágeis e pré-frágeis. No grupo de piora, o aumento do número de morbidades foi preditor para exaustão e/ou fadiga, enquanto que, no grupo de melhora, o aumento na dependência das atividades instrumentais de vida diária foi preditor para a perda de peso, e a diminuição dos escores do indicativo de depressão para o baixo nível de atividade física.

CONCLUSÃO:: houve maior percentual de mudança na condição de idosos não frágeis para pré-frágeis e as variáveis de saúde foram preditoras apenas para os componentes do fenótipo de fragilidade.

OBJETIVO

: describir los cambios en las condiciones de fragilidad a lo largo de un año después del alta hospitalaria, y verificar las variables predictoras del cambio de las condiciones de fragilidad y de los componentes del fenotipo de fragilidad, según grupos de empeoramiento, mejoría y estabilidad.

MÉTODO:: encuesta longitudinal, realizada con 129 ancianos. Se utilizó formulario estructurado para recoger datos socioeconómicos y salud; se utilizaron las escalas Depresión Geriátrica Abreviada (GDS-15), Actividades Básicas de Vida Diaria de Katz, Actividades Instrumentales de Vida Diaria de Lawton y Brody, y Fenotipo de Fragilidad, según Fried. Se procedió al análisis descriptivo y modelo de regresión logística multinomial (p<0,05).

RESULTADOS

: se constató que 56,7% de los ancianos cambiaron su condición de no-frágiles para prefrágiles, no habiendo ocurriendo cambio de los no-frágiles para frágiles. Se observó muerte entre ancianos frágiles y prefrágiles. En el grupo de empeoramiento, el aumento del número de morbilidades fue predictor para agotamiento y/o fatiga, en cuanto en el grupo de mejoría, el aumento en la dependencia de las actividades instrumentales de vida diaria fue predictor para la pérdida de peso y la disminución de los puntajes del indicativo de depresión para el bajo nivel de actividad física.

CONCLUSIÓN:: hubo mayor porcentaje de cambio en la condición de ancianos no-frágiles para prefrágiles y las variables de salud fueron predictoras apenas para los componentes del fenotipo de fragilidad.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c31/5510999/2d848c7387be/0104-1169-rlae-25-e2905-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c31/5510999/2d848c7387be/0104-1169-rlae-25-e2905-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c31/5510999/2d848c7387be/0104-1169-rlae-25-e2905-gf1.jpg
摘要

目的

描述出院后一年内虚弱状况的变化,验证根据恶化、改善和稳定组划分的虚弱状况及虚弱表型组成部分变化的预测变量。

方法

对129名老年人进行纵向调查。使用了社会经济和健康数据的结构化表格、量表(老年抑郁量表简版、 Katz量表、Lawton和Brody量表)以及根据Fried标准的虚弱表型。进行了描述性分析和多项逻辑回归模型(p<0.05)分析。

结果

我们发现56.7%的老年人从非虚弱状态转变为虚弱前期状态,未出现从非虚弱转变为虚弱的情况。在虚弱和虚弱前期老年人中发现了死亡病例。在恶化组中,发病数量增加是疲惫和/或疲劳的预测因素,而在改善组中,对日常生活工具性活动的依赖性增加是体重减轻以及因身体活动水平低导致抑郁评分降低的预测因素。

结论

观察到从非虚弱状态转变为虚弱前期状态的老年人比例更高,且健康变量仅对虚弱表型组成部分具有预测性。

目的

描述出院后一年内虚弱状况的变化,并验证根据恶化、改善和稳定组划分的虚弱状况及虚弱表型组成部分变化的预测变量。

方法

对129名老年人进行纵向调查。使用了社会经济和健康数据的结构化表格、量表(老年抑郁量表简版、Katz量表、Lawton和Brody量表)以及根据Fried标准的虚弱表型。进行了描述性分析和多项逻辑回归模型(p<0.05)分析。

结果

发现56.7%的老年人从非虚弱状态转变为虚弱前期状态,未出现从非虚弱转变为虚弱的情况。在虚弱和虚弱前期老年人中发现了死亡病例。在恶化组中,发病数量增加是疲惫和/或疲劳的预测因素,而在改善组中,对日常生活工具性活动的依赖性增加是体重减轻以及因身体活动水平低导致抑郁评分降低的预测因素。

结论

从非虚弱老年人转变为虚弱前期老年人的比例更高,且健康变量仅对虚弱表型组成部分具有预测性。

目的

描述出院后一年内虚弱状况的变化,并验证根据恶化、改善和稳定组划分的虚弱状况及虚弱表型组成部分变化的预测变量。

方法

对129名老年人进行纵向调查。使用了收集社会经济和健康数据的结构化表格;使用了老年抑郁量表简版(GDS-15)、Katz日常生活基本活动量表、Lawton和Brody日常生活工具性活动量表以及根据Fried标准的虚弱表型。进行了描述性分析和多项逻辑回归模型(p<0.05)分析。

结果

发现56.7%的老年人从非虚弱状态转变为虚弱前期状态,未出现从非虚弱转变为虚弱的情况。在虚弱和虚弱前期老年人中发现了死亡病例。在恶化组中,发病数量增加是疲惫和/或疲劳的预测因素,而在改善组中,对日常生活工具性活动的依赖性增加是体重减轻以及因身体活动水平低导致抑郁评分降低的预测因素。

结论

从非虚弱老年人转变为虚弱前期老年人的比例更高,且健康变量仅对虚弱表型组成部分具有预测性。

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