Advanced Center for Chronic Diseases (ACCDiS), Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile; Faculty of Education, Universidad Autónoma de Chile, Cinco poniente 1670, Talca, Chile.
Public Health Department, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile.
Arch Gerontol Geriatr. 2019 May-Jun;82:114-119. doi: 10.1016/j.archger.2019.01.012. Epub 2019 Feb 10.
Aging presents an emerging health and social challenge. We report the prevalence of frailty, its association with chronic diseases and the risk of hospitalization or death within 29 months.
Cross-sectional and prospective study. From 2014 to 2017, we examined frailty in an agricultural population in Chile. We enrolled 619 individuals aged 60-74 years from the Maule Cohort. Measured frailty prevalence, based the presence of ≥3 of the five factors (unintentional weight loss, weakness, slowness, self-reported exhaustion, low physical activity). We explored chronic diseases as predictors of frailty with multinomial regression models (sex, age, and schooling adjusted), and the risk of hospitalization and mortality by frailty status, with Cox regression models and Kaplan-Meier survival curves.
6% of participants were frail; women had higher prevalence of frailty (8.2%) than men (2.3%, <0.001). Diabetes was a risk factor of frailty (Relative Risk Ratio: 3.91; 95% CI: 1.84-8.32). The incidence of hospitalization was 32% in frail (Hazard Ratio, HR: 3.68; 95% CI: 1.77-7.63), 16% in pre-frail (HR: 1.91; 95% CI: 1.19-3.08) and 9% in robust participants. Among the participants, men had higher risk of hospitalization than women (7.1 and 4.1 per 1000 person-month, p = .014). In all mortality was higher among men than women (1.0 and 0.2 per 1000 person-month, p = .031).
In this agricultural population, diabetes was main chronic disease as risk factor of frailty. Frail older adults had higher risk of hospitalization than robust people, and especially men, had higher risk of adverse health event in a short-term.
老龄化带来了新的健康和社会挑战。我们报告了衰弱的流行率,及其与慢性病的关系,以及 29 个月内住院或死亡的风险。
横断面和前瞻性研究。2014 年至 2017 年,我们在智利的一个农业人群中检查了衰弱情况。我们从莫莱队列中招募了 619 名 60-74 岁的个体。根据存在的≥5 个因素(非故意体重减轻、虚弱、缓慢、自我报告的疲惫、低体力活动)来衡量衰弱的流行率。我们使用多变量回归模型(性别、年龄和教育程度调整)探索慢性病作为衰弱的预测因素,并使用 Cox 回归模型和 Kaplan-Meier 生存曲线根据衰弱状况来探索住院和死亡的风险。
6%的参与者衰弱;女性的衰弱患病率(8.2%)高于男性(2.3%,<0.001)。糖尿病是衰弱的危险因素(相对风险比:3.91;95%置信区间:1.84-8.32)。衰弱者的住院发生率为 32%(危险比,HR:3.68;95%置信区间:1.77-7.63),衰弱前者为 16%(HR:1.91;95%置信区间:1.19-3.08),健壮者为 9%。在参与者中,男性的住院风险高于女性(每 1000 人月 7.1 和 4.1 例,p=0.014)。所有死亡中,男性高于女性(每 1000 人月 1.0 和 0.2 例,p=0.031)。
在这个农业人群中,糖尿病是衰弱的主要慢性病危险因素。衰弱的老年人住院风险高于健壮者,尤其是男性,在短期内更易发生不良健康事件。