do Carmo Correia de Lima M, Loffredo Bilton T, Jefferson de Sousa Soares W, Paccini Lustosa L, Ferriolli E, Rodrigues Perracini M
Monica Rodrigues Perracini, Faculty of Medical Sciences, Universidade Estadual de Campinas, São Paulo, Brazil;
J Frailty Aging. 2019;8(1):39-41. doi: 10.14283/jfa.2018.44.
This study investigates the diagnostic accuracy of the combination of usual walking speed (UWS) and maximum walking speed (MWS) to identify frailty in community-dwelling older adults. A population-based study with 758 participants aged 65 and older was conducted. Frailty syndrome was determined using the Fried phenotype. UWS and MWS were evaluated in a 4.6-meter path. Both measures were categorized using the 1.0 m/s cut points, and participants were categorized into three groups: those with "very good", "good" and "insufficient" walking reserve capacity (WRC). Of all participants, 9% were identified as frail and 47% as prefrail. The "insufficient" WRC presented a low sensitivity of 0.55, high specificity of 0.91 and moderately useful likelihood ratios (LR+ 6.57, LR- 0.48) to identify frailty. Based on Fagan's nomogram, an elder's corresponding post-test probability of being frail with an "insufficient" WRC would be around 40%, which substantially increased the diagnostic accuracy of frailty.
本研究调查了常用步行速度(UWS)和最大步行速度(MWS)相结合对社区居住老年人衰弱的诊断准确性。开展了一项基于人群的研究,纳入了758名65岁及以上的参与者。采用Fried表型确定衰弱综合征。在一条4.6米的路径上评估UWS和MWS。两种测量指标均采用1.0米/秒的切点进行分类,参与者被分为三组:步行储备能力(WRC)“非常好”、“好”和“不足”的组。在所有参与者中,9%被确定为衰弱,47%为衰弱前期。“不足”的WRC对衰弱的识别敏感性较低,为0.55,特异性较高,为0.91,似然比适中(阳性似然比6.57,阴性似然比0.48)。根据费根氏诺模图,WRC“不足”的老年人衰弱的相应验后概率约为40%,这大大提高了衰弱的诊断准确性。