用自我报告问题替代 Fried 的基于表现的身体虚弱标准。

Substitution of Fried's performance-based physical frailty criteria with self-report questions.

机构信息

Centre of Research Autonomy and Participation for Persons with a Chronic Illness, Faculty of Health, Zuyd University of Applied Sciences, P.O. Box 550, 6400 AN Heerlen, The Netherlands; CAPHRI, Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.

Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089A, 1081 HV Amsterdam, The Netherlands.

出版信息

Arch Gerontol Geriatr. 2018 Mar-Apr;75:91-95. doi: 10.1016/j.archger.2017.11.009. Epub 2017 Nov 27.

DOI:10.1016/j.archger.2017.11.009

PMID:29202326

Abstract

OBJECTIVE

To identify self-report questions that can substitute Fried's performance-based frailty measures for use in large-scale studies and daily practice.

METHODS

A cross-sectional study was conducted among community dwelling older people (65+). Based on a literature search and interviews with older people and experts, 11 questions concerning walk time and 10 on handgrip strength were selected. All participants completed these sets of self-report questions as well as the original Fried criteria (including performance-based tests). Regression analyses were performed to find the questions that best substituted the performance-based tests.

RESULTS

In total, 135 individuals (mean age 73.8±7.0, 58.5% female) in different stages of frailty (non-frail 38.5%, pre-frail 40.7%, frail 20.7%) were included. Regression analyses revealed four questions for walk time and two for handgrip strength. Cut-off values of three for walk time (range 0-5) and one for handgrip strength (range 0-3) seem most optimal. This resulted in a sensitivity of 69.2%, 86.1% specificity and 79.4% agreement for walk time and a sensitivity of 73.2%, 71.3% specificity and 71.9% agreement for handgrip strength. The comparison of frailty stages using frailty criteria including the performance-based measures and scores based solely on self-report questions, resulted in an observed agreement of 71.1% (kappa value=0.55).

CONCLUSIONS

Considering the agreement between the questions and the performance-based tests, these two sets of questions might be used in settings where the performance-based tests of walk time and handgrip strength are unfeasible, such as in daily practice and large-scale research.

摘要

目的

确定可替代弗里德基于表现的衰弱测量的自我报告问题，以便在大规模研究和日常实践中使用。

方法

一项横断面研究在社区居住的老年人（65 岁以上）中进行。基于文献检索和对老年人及专家的访谈，选择了 11 个关于步行时间的问题和 10 个关于握力的问题。所有参与者都完成了这两套自我报告问题以及原始的弗里德标准（包括基于表现的测试）。回归分析用于找到最能替代基于表现的测试的问题。

结果

共纳入了处于不同衰弱阶段的 135 名个体（平均年龄 73.8±7.0 岁，58.5%为女性）（非衰弱 38.5%，衰弱前期 40.7%，衰弱 20.7%）。回归分析显示，步行时间有四个问题，握力有两个问题。步行时间的三个（范围 0-5）和握力的一个（范围 0-3）的截断值似乎最优化。这导致步行时间的灵敏度为 69.2%，特异性为 86.1%，一致性为 79.4%，握力的灵敏度为 73.2%，特异性为 71.3%，一致性为 71.9%。使用包括基于表现的测量和仅基于自我报告问题的得分的衰弱标准比较衰弱阶段，观察到的一致性为 71.1%（kappa 值=0.55）。