Albala Cecilia, Lera Lydia, Sanchez Hugo, Angel Barbara, Márquez Carlos, Arroyo Patricia, Fuentes Patricio
Public Health Nutrition Unit, Institute of Nutrition and Food Technology (INTA), University of Chile.
Faculty of Medicine, Clinical Hospital, University of Chile, Santiago, Chile.
Clin Interv Aging. 2017 Jun 26;12:995-1001. doi: 10.2147/CIA.S136906. eCollection 2017.
Age-associated brain physiologic decline and reduced mobility are key elements of increased age-associated vulnerability.
To study the frequency of frailty phenotype and its association with mental health and survival in older Chileans.
Follow-up of ALEXANDROS cohorts designed to study disability associated with obesity in community-dwelling people 60 years and older living in Santiago, Chile. At baseline, 2,098 (67% women) of 2,372 participants had the necessary measurements for the identification of the frailty phenotype: weak handgrip dynamometry, unintentional weight loss, fatigue/exhaustion, five chair-stands/slow walking speed and difficulty walking (low physical activity). After 10-15 years, 1,298 people were evaluated and 373 had died. Information regarding deaths was available for the whole sample.
The prevalence of frailty at baseline (≥3 criteria) in the whole sample was 13.9% (women 16.4%; men 8.7%) and the pre-frailty prevalence (1-2 criteria) was 63.8% (65.0% vs 61.4%), respectively. Frailty was associated with cognitive impairment (frail 48.1%; pre-frail 21.7%; nonfrail 20.5%, <0.001) and depression (frail 55.1%; pre-frail 27.3%; nonfrail 18.8%, <0.001). Logistic regression models for frailty adjusted for sex and age showed a strong association between frailty and mild cognitive impairment (MCI) (odds ratio [OR] =3.93; 95% CI: 1.41-10.92). Furthermore, an important association was found for depression and frailty (OR =2.36; 95% CI 1.82-3.06). Age- and sex-adjusted hazard ratios (HRs) for death showed an increased risk with increasing frailty: pre-frail HR =1.56 (95% CI: 1.07-2.29), frail HR =1.91 (95% CI: 1.15-3.19); after adjustment by age and sex, a higher risk of death was observed for people identified as frail (HR =1.56, =0.014) and pre-frail (HR =1.30, =0.065). MCI and dementia were also risk factors for death (MCI: HR =1.69, <0.027; dementia: HR =1.66, =0.016).
Frailty is highly prevalent and strongly associated with cognitive impairment and depression in older Chileans. The risk for death was higher for frail people, but underlying cognitive impairment is a key component of the lower survival rate.
与年龄相关的大脑生理衰退和活动能力下降是与年龄相关的易损性增加的关键因素。
研究智利老年人衰弱表型的发生率及其与心理健康和生存的关系。
对ALEXANDROS队列进行随访，该队列旨在研究智利圣地亚哥60岁及以上社区居民中与肥胖相关的残疾情况。在基线时，2372名参与者中有2098名（67%为女性）进行了确定衰弱表型所需的测量：握力弱、非故意体重减轻、疲劳/疲惫、五次从椅子上起身/步行速度慢和行走困难（身体活动量低）。10 - 15年后，对1298人进行了评估，373人死亡。整个样本都有关于死亡的信息。
整个样本中基线时衰弱（≥3项标准）的患病率为13.9%（女性为16.4%；男性为8.7%），衰弱前期（1 - 2项标准）的患病率分别为63.8%（65.0%对61.4%）。衰弱与认知障碍相关（衰弱者为48.1%；衰弱前期者为21.7%；非衰弱者为20.5%，<0.001）以及与抑郁相关（衰弱者为55.1%；衰弱前期者为27.3%；非衰弱者为18.8%，<0.001）。针对性别和年龄调整后的衰弱逻辑回归模型显示，衰弱与轻度认知障碍（MCI）之间存在强关联（比值比[OR]=3.93；95%置信区间：1.41 - 10.92）。此外，发现抑郁与衰弱之间存在重要关联（OR =2.36；95%置信区间1.82 - 3.06）。年龄和性别调整后的死亡风险比（HRs）显示，随着衰弱程度增加死亡风险升高：衰弱前期HR =1.56（95%置信区间：1.07 - 2.29），衰弱HR =1.91（95%置信区间：1.15 - 3.19）；在按年龄和性别调整后，被确定为衰弱者（HR =1.56，=0.014）和衰弱前期者（HR =1.30，=0.065）的死亡风险更高。MCI和痴呆也是死亡的危险因素（MCI：HR =1.69，<0.027；痴呆：HR =1.66，=0.016）。
衰弱在智利老年人中非常普遍，且与认知障碍和抑郁密切相关。衰弱者的死亡风险更高，但潜在的认知障碍是生存率较低的关键因素。
