Department of Health Care Administration, Chang Jung Christian University, No.1 Changda Rd., Gueiren District, Tainan City 71101, Taiwan, ROC.
Department of Occupational Therapy & Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No.1 University Road, Tainan City 701, Taiwan, ROC.
Arch Gerontol Geriatr. 2018 Jan;74:32-38. doi: 10.1016/j.archger.2017.09.005. Epub 2017 Sep 18.
The Vulnerable Elders Survey-13 (VES-13) has been used as a screening tool to identify vulnerable community-dwelling older persons for more in-depth assessment and targeted interventions. Although many studies supported its use in different populations, few have addressed Asian populations. The optimal scaling system for the VES-13 in predicting health outcomes also has not been adequately tested. This study (1) assesses the applicability of the VES-13 to predict the mortality of community-dwelling older persons in Taiwan, (2) identifies the best scaling system for the VES-13 in predicting mortality using generalized additive models (GAMs), and (3) determines whether including covariates, such as socio-demographic factors and common geriatric syndromes, improves model fitting.
This retrospective longitudinal cohort study analyzed the data of 2184 community-dwelling persons 65 years old or older from the 2003 wave of the national-wide Taiwan Longitudinal Study on Aging. Cox proportional hazards models and Generalized Additive Models (GAMs) were used.
The VES-13 significantly predicted the mortality of Taiwan's community-dwelling elders. A one-point increase in the VES-13 score raised the risk of death by 26% (hazard ratio, 1.26; 95% confidence interval, 1.21-1.32). The hazard ratio of death increased linearly with each additional VES-13 score point, suggesting that using a continuous scale is appropriate. Inclusion of socio-demographic factors and geriatric syndromes improved the model-fitting.
The VES-13 is appropriate for an Asian population. VES-13 scores linearly predict the mortality of this population. Adjusting the weighting of the physical activity items may improve the performance of the VES-13.
脆弱老年人调查-13 （VES-13）已被用作筛选工具，以识别脆弱的社区居住老年人，以便进行更深入的评估和有针对性的干预。尽管许多研究支持其在不同人群中的使用，但很少有研究涉及亚洲人群。VES-13 预测健康结果的最佳缩放系统也没有得到充分测试。本研究（1）评估 VES-13 在预测台湾社区居住老年人死亡率方面的适用性，（2）使用广义加性模型（GAMs）确定 VES-13 预测死亡率的最佳缩放系统，（3）确定是否包含协变量，如社会人口统计学因素和常见老年综合征，是否可以改善模型拟合。
这项回顾性纵向队列研究分析了来自全国性的台湾老龄化纵向研究 2003 年波的 2184 名 65 岁或以上的社区居住者的数据。使用 Cox 比例风险模型和广义加性模型（GAMs）。
VES-13 显著预测了台湾社区居住老年人的死亡率。VES-13 评分增加一分，死亡风险增加 26%（风险比，1.26；95%置信区间，1.21-1.32）。死亡风险的风险比随每个额外的 VES-13 评分点线性增加，表明使用连续尺度是合适的。纳入社会人口统计学因素和老年综合征可改善模型拟合。
VES-13 适用于亚洲人群。VES-13 评分线性预测该人群的死亡率。调整身体活动项目的权重可能会提高 VES-13 的性能。
