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社区居住的膝骨关节炎老年人群中衰弱和认知衰弱的流行情况及相关因素分析。

Prevalence and Factors Associated with Frailty and Cognitive Frailty Among Community-Dwelling Elderly with Knee Osteoarthritis.

机构信息

Department of Preventive and Social Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.

Department of Thai Traditional and Alternative Medicine, Ministry of Public Health, Mueang Nonthaburi District, Nonthaburi, Thailand.

出版信息

J Community Health. 2019 Jun;44(3):587-595. doi: 10.1007/s10900-018-00614-5.

Abstract

Physical frailty and cognitive impairment are risk factors for adverse outcomes in older people with osteoarthritis of the knee (knee OA). This cross-sectional study was conducted to determine the prevalence and associated factors of frailty and cognitive frailty among community-dwelling older patients with knee OA in four representative cities of Thailand. Data composed of three parts, Part 1: Demographic data, Part 2: The assessment of frailty by Fried phenotype and cognitive function by MiniCog and Part 3: The assessment of factors associated with frailty. Of 780 elders (mean age, 69.4 ± 6.9 years) screened, 101 (12.9%) were classified to be frail, 511 (65.6%) pre-frail and 168 (21.5%) non-frail. The prevalence of cognitive frailty was 2.44%. The correlation between physical activity rated by the Global Physical Activity Questionnaire (GPAQ) and self-rated methods was high (kappa 0.721; p < 0.001). Self-rated physical activity yielded similar prevalence of frail (9.4%), pre-frail (69.1%) and non-frail (21.5%). In multivariate analysis, aging (OR 3.42; 95% CI 1.16-10.11), severe knee OA symptoms (OR 18.96; 95% CI 3.53-101.65), malnutrition (OR 2.50; 95% CI 1.23-5.09), and functional dependence (OR 3.94; 95% CI 1.19-13.03) were associated with frailty. The prevalence of frailty and pre-frailty was high in knee OA and associated with aging, severe knee OA symptoms, malnutrition, and functional dependence, whereas the prevalence of cognitive frailty was not uncommon in community-dwelling elderly. Physical activity rated by the GPAQ and self-rated methods were highly correlated. Self-rated physical activity may be used in community surveys of frailty.

摘要

身体虚弱和认知障碍是老年膝骨关节炎(膝 OA)患者不良结局的危险因素。本横断面研究旨在确定泰国四个代表性城市社区居住的老年膝骨关节炎患者中虚弱和认知虚弱的患病率和相关因素。数据由三部分组成,第 1 部分:人口统计学数据,第 2 部分:通过 Fried 表型评估虚弱和通过 MiniCog 评估认知功能,第 3 部分:评估与虚弱相关的因素。在筛选的 780 名老年人(平均年龄 69.4 ± 6.9 岁)中,101 名(12.9%)被归类为虚弱,511 名(65.6%)为虚弱前期,168 名(21.5%)为非虚弱。认知虚弱的患病率为 2.44%。全球体力活动问卷(GPAQ)和自我评估方法评估的体力活动之间存在高度相关性(kappa 0.721;p<0.001)。自我评估的体力活动得出的虚弱(9.4%)、虚弱前期(69.1%)和非虚弱(21.5%)的患病率相似。多变量分析显示,年龄(OR 3.42;95% CI 1.16-10.11)、严重膝骨关节炎症状(OR 18.96;95% CI 3.53-101.65)、营养不良(OR 2.50;95% CI 1.23-5.09)和功能依赖(OR 3.94;95% CI 1.19-13.03)与虚弱相关。膝骨关节炎患者虚弱和虚弱前期的患病率较高,与年龄、严重膝骨关节炎症状、营养不良和功能依赖有关,而社区居住的老年人中认知虚弱的患病率并不罕见。GPAQ 评估的体力活动和自我评估方法高度相关。自我评估的体力活动可用于社区虚弱调查。

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