养老院居民的身体状况和虚弱指数：INCUR 研究的结果。
Physical status and frailty index in nursing home residents: Results from the INCUR study.
机构信息
Centre Hospitalier Universitaire de Guadeloupe, Université des Antilles, France; Centre INSERM U 1219, Université de Bordeaux, France; ISPED, Université de Bordeaux, France; Gérontopôle CHU de Toulouse, France.
Centre INSERM U 1219, Université de Bordeaux, France; ISPED, Université de Bordeaux, France.
出版信息
Arch Gerontol Geriatr. 2018 Jan;74:72-76. doi: 10.1016/j.archger.2017.10.005. Epub 2017 Oct 12.
AIM
The Short Physical Performance Battery (SPPB) is a widely used instrument for measuring physical performance, consisting of 3 sub-tests: a hierarchical test of balance, a gait speed test, and a chair stand test. Although equally considered in the computation of the SPPB score, each of the components may present a specific and different weight in clinical practice. The aim of this study was to estimate the relationship between SPPB and its component of an age-related deficit accumulation index (the so-called Frailty Index [FI] proposed by Rockwood).
METHOD
Data are from a longitudinal cohort study (ie, the Incidence of pNeumonia and related ConseqUences in nursing home Residents [INCUR]) of 730 older persons (74.29% women) living in 13 French nursing homes. The FI was computed as the ratio between 30 actual and potential deficits the participant might have presented at the baseline visit (range between 0 [no deficit] and 1 [30 deficits]). Physical status was assessed using the SPPB score at baseline. Descriptive statistics and linear regression analyses were used to determine the relationship between the SPPB and FI and estimate which components of the SPPB were most strongly associated with the FI.
RESULTS
Mean age of participants was 86.5 (SD 7.5) years, with a mean FI of 0.37 (SD 0.11) and SPPB of 2.5 (range between 0 and 12). The SPPB and its components were all significantly associated with the FI, but the magnitude of the associations varied. Linear regression analyses adjusted for age, sex, showed that the balance test [beta=-0.045 (95%CI -0.042; -0.028), p<0.0001] and chair stand test [beta=-0.040 (95%CI -0.054; -0.027), p<0.0001] was more strongly associated with the FI than the gait speed [beta=-0.015 (95%CI -0.021; -0.008), p<0.0001].
CONCLUSION
Of the 3 components of the SPPB, both balance and chair tests seem particularly relevant indicator of frailty among very old and complex elders living in nursing homes.
目的
短体物理表现电池（SPPB）是一种广泛用于测量身体表现的工具，由 3 个子测试组成：平衡分级测试、步态速度测试和椅子站立测试。尽管在 SPPB 评分的计算中同样被考虑，但每个组成部分在临床实践中可能具有特定且不同的权重。本研究的目的是估计 SPPB 与其组成部分（即 Rockwood 提出的年龄相关缺陷积累指数，即所谓的脆弱指数 [FI]）之间的关系。
方法
数据来自一项纵向队列研究（即 Incidence of pNeumonia and related ConseqUences in nursing home Residents [INCUR]），共有 730 名老年人（74.29%为女性）居住在 13 家法国养老院。FI 是通过计算参与者在基线时可能出现的 30 种实际和潜在缺陷的比率得出的（范围在 0 [无缺陷] 和 1 [30 个缺陷] 之间）。身体状况使用 SPPB 评分在基线时进行评估。使用描述性统计和线性回归分析来确定 SPPB 与 FI 之间的关系，并估计 SPPB 的哪些组成部分与 FI 最密切相关。
结果
参与者的平均年龄为 86.5（7.5）岁，FI 的平均值为 0.37（0.11），SPPB 的平均值为 2.5（范围在 0 到 12 之间）。SPPB 及其组成部分均与 FI 显著相关，但关联的大小不同。调整年龄和性别后的线性回归分析表明，平衡测试 [β=-0.045（95%CI-0.042；-0.028），p<0.0001] 和椅子站立测试 [β=-0.040（95%CI-0.054；-0.027），p<0.0001] 与 FI 的关联比步态速度 [β=-0.015（95%CI-0.021；-0.008），p<0.0001] 更强。
结论
在 SPPB 的 3 个组成部分中，平衡和椅子测试似乎是养老院中非常年老和复杂的老年人虚弱的特别相关指标。
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