Puts Martine T E, Lips Paul, Ribbe Miel W, Deeg Dorly J H
Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, Amsterdam, The Netherlands.
VU University Medical Center, LASA, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
Eur J Ageing. 2005 Nov 9;2(4):264-274. doi: 10.1007/s10433-005-0011-z. eCollection 2005 Dec.
The aim of this study was to determine the effect of frailty on the risk of residential/nursing home admission independently of chronic diseases and functional limitations. Frailty consists of multisystem decline and is considered to be a consequence of changes in neuromuscular, endocrine and immune system functioning that occur as people age. Frailty is a combination of multiple impairments in functioning that might lead to functional limitations and disability but it is not clear whether frailty has an independent effect on residential/nursing home admission. Data were used from the Longitudinal Aging Study Amsterdam. The respondents participated at both (1992/1993) and (1995/1996), lived independently at , and were aged 65 and over (=1,503). Nine frailty markers were assessed at two cycles ( and ). The frailty markers were defined in two ways: low functioning at (static frailty); and change in functioning between and (dynamic frailty). The outcome variable was residential/nursing home admission between and (2001/2002). Cox proportional hazard analyses were used adjusting for chronic diseases, functional limitations, care received, partner status, income, age and sex. Static (RR 1.93, 95%CI 1.36-2.74) and dynamic frailty (RR 1.69, 95%CI 1.19-2.39) were associated with institutionalization in both men and women independently of the effect of chronic diseases and functional limitations. Additional analyses of the total number of both sets of frailty markers present revealed an increased risk of institutionalization when the number increased. In conclusion, frailty is associated with institutionalization, independently of the effect of chronic diseases and functional limitations.
本研究的目的是确定衰弱对入住住宅/养老院风险的影响，且独立于慢性疾病和功能受限因素。衰弱由多系统衰退构成，被认为是随着人们年龄增长，神经肌肉、内分泌和免疫系统功能发生变化的结果。衰弱是多种功能损害的组合，可能导致功能受限和残疾，但尚不清楚衰弱对入住住宅/养老院是否有独立影响。数据来自阿姆斯特丹纵向衰老研究。受访者在1992/1993年和1995/1996年参与研究，在1995/1996年独立生活，年龄在65岁及以上（n = 1503）。在两个周期（1992/1993年和1995/1996年）评估了九个衰弱标志物。衰弱标志物通过两种方式定义：1995/1996年功能低下（静态衰弱）；以及1992/1993年至1995/1996年期间功能变化（动态衰弱）。结局变量是2001/2002年期间入住住宅/养老院情况。使用Cox比例风险分析，并对慢性疾病、功能受限、接受的护理、伴侣状况、收入、年龄和性别进行了校正。静态衰弱（风险比1.93，95%置信区间1.36 - 2.74）和动态衰弱（风险比1.69，95%置信区间1.19 - 2.39）与男性和女性入住养老院均相关，且独立于慢性疾病和功能受限的影响。对两组衰弱标志物总数的进一步分析显示，当数量增加时，入住养老院的风险增加。总之，衰弱与入住养老院相关，且独立于慢性疾病和功能受限的影响。
