The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China.
Department of Healthcare, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China.
Aging Clin Exp Res. 2018 Dec;30(12):1445-1452. doi: 10.1007/s40520-018-1041-7. Epub 2018 Sep 26.
Little is known about frailty in Chinese nursing home residents.
(1) To evaluate the prevalence of frailty in nursing home residents according to the FI-Lab or FRAIL-NH; and (2) to compare the predictive validity of these two tools for mortality.
We conducted a prospective study in four nursing homes in China. Frailty was assessed using the fatigue, resistance, ambulation, illness, loss of weight, nutrition, and help with dressing questionnaire (FRAIL-NH) and frailty index based on common laboratory tests (FI-Lab), respectively. The survival status was collected via medical records or telephone interviews. Receiver-operating characteristic (ROC) curves were calculated to estimate the area under the ROC curves (AUCs) for FI-Lab and FRAIL-NH in relation to mortality. Cox proportional hazard models were applied to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality by FRAIL-NH and FI-Lab, separately.
We included 329 participants. The FI-Lab score was significantly and strongly associated with the FRAIL-NH score (r = 0.799, p < 0.001). Frailty was defined as the FI-Lab score ≥ 0.3 or the FRAIL-NH score ≥ 6, and the prevalence of frailty was 56.2% and 58.7%, respectively. Seventy-three participants (22.7%) died during the 1-year follow-up. The FI-Lab (AUC 0.700, 95% CI 0.647-0.750) was slightly better than the FRAIL-NH (AUC 0.676, 95% CI 0.622-0.727) for predicting mortality (p = 0.025). After adjusted for age and gender, the increment of the FI-Lab score was associated with mortality (adjusted HR per 0.01 increment in score 1.07, 95% CI 1.05-1.09), the increment of the FRAIL-NH score was also associated with mortality (adjusted HR per 1 increment in score 1.28, 95% CI 1.19-1.46).
The FI-Lab and FRAIL-NH are valuable for predicting mortality in Chinese nursing home residents.
关于中国养老院居民的虚弱问题知之甚少。
（1）根据 FI-Lab 或 FRAIL-NH 评估养老院居民虚弱的患病率；（2）比较这两种工具对死亡率的预测效度。
我们在中国的 4 家养老院进行了一项前瞻性研究。使用疲劳、抵抗力、活动能力、疾病、体重减轻、营养和穿衣帮助问卷（FRAIL-NH）和基于常见实验室检查的衰弱指数（FI-Lab）分别评估衰弱。通过病历或电话访谈收集生存状况。计算受试者工作特征（ROC）曲线以估计 FI-Lab 和 FRAIL-NH 与死亡率相关的 ROC 曲线下面积（AUC）。应用 Cox 比例风险模型分别计算 FRAIL-NH 和 FI-Lab 与死亡率相关的危险比（HR）和 95%置信区间（CI）。
我们纳入了 329 名参与者。FI-Lab 评分与 FRAIL-NH 评分显著且高度相关（r=0.799，p<0.001）。虚弱定义为 FI-Lab 评分≥0.3 或 FRAIL-NH 评分≥6，虚弱的患病率分别为 56.2%和 58.7%。在 1 年的随访期间，73 名参与者（22.7%）死亡。FI-Lab（AUC 0.700，95%CI 0.647-0.750）预测死亡率的效果略优于 FRAIL-NH（AUC 0.676，95%CI 0.622-0.727）（p=0.025）。在调整年龄和性别后，FI-Lab 评分的增加与死亡率相关（每增加 0.01 分的调整 HR 为 1.07，95%CI 1.05-1.09），FRAIL-NH 评分的增加也与死亡率相关（每增加 1 分的调整 HR 为 1.28，95%CI 1.19-1.46）。
FI-Lab 和 FRAIL-NH 可用于预测中国养老院居民的死亡率。
