评估中国养老院老年人的虚弱程度：衰弱 NH 量表与衰弱指数的比较。
Assessing Frailty in Chinese Nursing Home Older Adults: A Comparison between the Frail-NH Scale and Frailty Index.
机构信息
Minhui Liu and Siyuan Tang, Central South University Xiangya Nursing School, Changsha, Hunan, China,
出版信息
J Nutr Health Aging. 2019;23(3):291-298. doi: 10.1007/s12603-019-1156-3.
OBJECTIVE
(1) To establish appropriate FRAIL-NH cutoff points in nursing homes in Mainland China; (2) To compare the FRAIL-NH scale and Frailty Index in assessing frailty prevalence and associated factors in nursing homes.
DESIGN
A cross-sectional study.
SETTING
Six nursing homes in Changsha, China.
PARTICIPANTS
A total of 302 residents aged 60 years or older (mean aged 82.71±8.49, 71.2% female).
MEASUREMENTS
Frailty was assessed using the 34-item Frailty Index and the FRAIL-NH scale.
RESULTS
The appropriate FRAIL-NH cutoff points to classify frail status and frailest status were 1.5 (87.6% sensitivity, 63.3% specificity) and 7.5 (94.1% sensitivity, 73.4% specificity), respectively. Based on the FRAIL-NH and Frailty Index, 69.5% (48% for frail and 21.5% for frailest), and 66.5% (60.9% for frail and 5.6% for frailest) of residents were at risk of frailty, respectively. There was no statistically significant difference in the total frailty prevalence assessed by FRAIL-NH and Frailty Index (χ2=0.617, P=0.432). The FRAIL-NH Scale is significantly associated with the Frailty Index (correlation coefficient (r) = 0.74, P < 0.001), but there was a Kappa agreement of 0.39 for frailty classification between the FRAIL-NH and Frailty Index, with the Frailty Index classifying a larger number of individuals as frail. When using FRAIL-NH scale, disease and self-reported health status were associated with frail and frailest status while age was just associated with frailest status. regarding the Frailty Index, age, diseases, medications and self-reported health status were associated with frail and frailest status.
CONCLUSION
The FRAIL-NH is a simple and effective tool to assess the overall frailty rate in nursing homes, and the Frailty Index may be more suitable capturing the multidimensionality of frailty at an individual level. Careful consideration in the selection of a frailty instrument, based on the intended purpose, is necessary.
目的
（1）在中国内地养老院建立合适的 FRAIL-NH 切点；（2）比较 FRAIL-NH 量表和衰弱指数在评估养老院衰弱流行率和相关因素方面的作用。
设计
横断面研究。
地点
中国长沙的 6 家养老院。
参与者
共有 302 名年龄在 60 岁及以上的居民（平均年龄 82.71±8.49 岁，71.2%为女性）。
测量方法
采用 34 项衰弱指数和 FRAIL-NH 量表评估衰弱。
结果
将 1.5（87.6%的敏感性，63.3%的特异性）和 7.5（94.1%的敏感性，73.4%的特异性）作为划分虚弱状态和最虚弱状态的合适 FRAIL-NH 切点。根据 FRAIL-NH 和衰弱指数，分别有 69.5%（48%为虚弱，21.5%为最虚弱）和 66.5%（60.9%为虚弱，5.6%为最虚弱）的居民存在衰弱风险。两种方法评估的总衰弱流行率无统计学差异（χ2=0.617，P=0.432）。FRAIL-NH 量表与衰弱指数显著相关（相关系数（r）=0.74，P<0.001），但 FRAIL-NH 与衰弱指数在衰弱分类方面的 Kappa 一致性为 0.39，衰弱指数将更多人分类为虚弱。使用 FRAIL-NH 量表时，疾病和自我报告的健康状况与虚弱和最虚弱状态相关，而年龄仅与最虚弱状态相关。对于衰弱指数，年龄、疾病、药物和自我报告的健康状况与虚弱和最虚弱状态相关。
结论
FRAIL-NH 是评估养老院总体衰弱率的简单有效工具，而衰弱指数可能更适合在个体水平上捕捉衰弱的多维性。基于预期目的，仔细考虑选择衰弱工具是必要的。
Zotero 插件