Federal University of Rio de Janeiro, Faculty of Medicine, Rua Rodolpho Paulo Rocco, 255/room 9E11, Cidade Universitária, Zip Code 21941- 913, Rio de Janeiro, RJ, Brazil; National School of Public Health/Oswaldo Cruz Foundation, Department of Epidemiology and Quantitative Methods, Rua Leopoldo Bulhões, 1480/room 817b, Manguinhos, Zip Code 21041-210, Rio de Janeiro, RJ, Brazil.
Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, De Boelelaan 1109, 1081 HV, Amsterdam, The Netherlands; Zonnehuisgroep Amstelland, Groenelaan 7, 1186 AA, Amstelveen, The Netherlands; Department of General Practice, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium.
Arch Gerontol Geriatr. 2018 May-Jun;76:114-119. doi: 10.1016/j.archger.2018.02.013. Epub 2018 Feb 22.
This study aimed to determine the predictive value of the Brazilian Tilburg Frailty Indicator (TFI) for adverse health outcomes (falls, hospitalization, disability and death), in a follow-up period of twelve months.
This longitudinal study was carried out with a sample of people using primary health care services in Rio de Janeiro, Brazil. At baseline the sample consisted of 963 people aged 60 years and older. A subset of all respondents participated again one year later (n = 640, 66.6% response rate). We used the TFI, the Katz's scale for assessing ADL disability and the Lawton Scale for assessing IADL disability. Falls, hospitalization and death were also assessed using a questionnaire.
The prevalence of frailty was 44.2% and the mean score of the TFI was 4.4 (SD = 3.0). There was a higher risk of loss in functional capacity in ADL (OR = 3.03, CI95% 1.45-6.29) and in IADL (OR = 1.51, CI95% 1.05-2.17), falls (OR = 2.08, CI95% 1.21-3.58), hospitalization (OR = 1.83, CI95% 1.10-3.06), and death (HR = 2.73, CI95% 1.04-7.19) for frail when compared to non-frail elderly, in the bivariate analyses. Controlling for the sociodemographic variables, the frailty domains together improved the prediction of hospitalization, falls and loss in functional capacity in ADL, but not loss in functional capacity in IADL.
The TFI is a good predictor of adverse health outcomes among elderly users of primary care services in Brazil and appears an adequate and easy to administer tool for monitoring their health conditions.
本研究旨在确定巴西蒂尔堡虚弱指数（TFI）对不良健康结局（跌倒、住院、残疾和死亡）的预测价值，随访时间为 12 个月。
这是一项在巴西里约热内卢使用初级保健服务的人群进行的纵向研究。在基线时，样本由 963 名 60 岁及以上的人组成。所有受访者的一部分在一年后再次参加（n=640，应答率为 66.6%）。我们使用 TFI、Katz 日常生活活动残疾量表和 Lawton 工具性日常生活活动残疾量表。还使用问卷评估跌倒、住院和死亡情况。
衰弱的患病率为 44.2%，TFI 的平均得分为 4.4（SD=3.0）。在日常生活活动（OR=3.03，95%CI95%1.45-6.29）和工具性日常生活活动（OR=1.51，95%CI95%1.05-2.17）、跌倒（OR=2.08，95%CI95%1.21-3.58）、住院（OR=1.83，95%CI95%1.10-3.06）和死亡（HR=2.73，95%CI95%1.04-7.19）方面，虚弱的老年人发生功能丧失的风险更高，与非虚弱的老年人相比，在单变量分析中。在控制了社会人口统计学变量后，虚弱领域共同提高了对住院、跌倒和日常生活活动中功能丧失的预测，但对工具性日常生活活动中功能丧失的预测没有提高。
TFI 是巴西初级保健服务老年患者不良健康结局的良好预测指标，似乎是一种合适且易于管理的工具，可用于监测他们的健康状况。
