Graduate School of Integrated Arts and Sciences, Kochi University, Kochi, Japan.
Section of the NILS-LSA, National Center for Geriatrics and Gerontology, Obu, Japan.
Geriatr Gerontol Int. 2018 Jul;18(7):1085-1092. doi: 10.1111/ggi.13316. Epub 2018 Apr 2.
The association between frailty and increased mortality risk is unknown. The present study assessed the longitudinal relationship between frailty and mortality risk in Japanese community-dwelling older adults.
Participants included 841 randomly chosen community-dwelling Japanese individuals, including 175 older adults aged 65-88 years with incomplete data at the baseline examination (July 2006-July 2008). Participants were followed from baseline to 31 December 2015 (mean 7.9 years). Frailty was diagnosed according to frailty criteria, including unintentional weight loss (shrinking), exhaustion, low activity, low grip strength and low gait speed. Information on deaths was obtained from a population dynamics survey. The relationship between frailty and mortality was assessed using Kaplan-Meier survival curves and Cox proportional hazards regression. The Cox proportional hazards model was used to control for potential confounders, including age at baseline, body fat, education, the Mini-Mental State Examination score, the Center for Epidemiologic Studies Depression Scale score, total physical activity, total caloric intake, alcohol intake, current smoking, household income and the number of current diseases.
The fully adjusted hazard ratio for all-cause mortality in the frailty group was 2.63 (95% confidence interval, 1.28-5.39; P for trend <0.01). The age- and sex-adjusted hazard ratio for mortality of cancer in the frailty group was 3.33 (95% confidence interval, 1.15-9.62; P for trend <0.05).
Complications of frailty, which include shrinking, exhaustion, low activity, weakness, and slowness, appear to be significant risks for mortality in Japanese older adults. Geriatr Gerontol Int 2018; 18: 1085-1092.
虚弱与死亡风险增加之间的关联尚不清楚。本研究评估了日本社区居住的老年人中虚弱与死亡风险之间的纵向关系。
参与者包括 841 名随机选择的社区居住的日本个体，其中包括 175 名年龄在 65-88 岁之间的老年人，在基线检查时数据不完整（2006 年 7 月至 2008 年 7 月）。参与者从基线随访至 2015 年 12 月 31 日（平均 7.9 年）。根据虚弱标准诊断虚弱，包括非故意体重减轻（消瘦）、乏力、活动减少、握力和步态速度降低。死亡信息从人口动态调查中获得。使用 Kaplan-Meier 生存曲线和 Cox 比例风险回归评估虚弱与死亡率之间的关系。Cox 比例风险模型用于控制潜在的混杂因素，包括基线时的年龄、体脂肪、教育程度、简易精神状态检查评分、流行病学研究抑郁量表评分、总体力活动、总热量摄入、酒精摄入、当前吸烟状况、家庭收入和当前疾病数量。
虚弱组全因死亡率的完全调整危险比为 2.63（95%置信区间，1.28-5.39；趋势 P<0.01）。虚弱组癌症死亡率的年龄和性别调整危险比为 3.33（95%置信区间，1.15-9.62；趋势 P<0.05）。
虚弱的并发症，包括消瘦、乏力、活动减少、虚弱和缓慢，似乎是日本老年人死亡的重要风险因素。老年医学与老年病学国际 2018；18：1085-1092。
