Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsstraße 6/I, Graz, Austria.
Age Ageing. 2019 Jul 1;48(4):547-552. doi: 10.1093/ageing/afz040.
frailty fluctuations, that is, within-person up and down deviations from individual long-term frailty index trajectories represent a hitherto both conceptually and empirically untapped facet of frailty among older adults.
to assess the size of frailty fluctuations in old age and their association with frailty levels, frailty growth as well as sex and socio-economic position.
a total of 18,704 biannual observations from 4,514 community-dwelling older adults (65+) in 10 European countries over 12 years from the Survey of Health, Ageing and Retirement in Europe (SHARE) were analysed. A frailty index was constructed based on 50 items. Long-term frailty trajectories and fluctuations were modelled simultaneously using Bayesian mixed-effects location-scale regression models.
frailty index fluctuations were non-negligible among older adults, amounting to 0.04/0.05 FI or 2.0/2.5 health deficits on average. 30% of fluctuations were between 0.04 and 0.1 FI (2 and 5 health deficits) and 8% were larger than 0.1 FI (5 health deficits). Fluctuations increased with age and frailty levels, and were higher among women, those with low socio-economic position (education) and individuals who died during follow-up.
frailty index fluctuations refer to instabilities in an older person's health status and represent a hitherto untapped but relevant aspect of vulnerability in old age. Future analysis of frailty fluctuations should be based on a larger number of repeated observations with shorter time intervals.
脆弱性波动，即个体长期脆弱指数轨迹内的个体上下偏差，代表了老年人脆弱性在概念和经验上尚未被挖掘的一个方面。
评估老年人脆弱性波动的程度及其与脆弱性水平、脆弱性增长以及性别和社会经济地位的关系。
对来自欧洲 10 个国家的 4514 名 65 岁以上社区居住的老年人在 12 年期间的欧洲健康、老龄化和退休研究（SHARE）中进行了总共 18704 次的两年一次的观察。根据 50 项指标构建了脆弱性指数。使用贝叶斯混合效应位置-尺度回归模型同时对长期脆弱性轨迹和波动进行建模。
老年人的脆弱性指数波动不可忽视，平均波动幅度为 0.04/0.05 FI 或 2.0/2.5 健康缺陷。30%的波动幅度在 0.04 到 0.1 FI 之间（2 到 5 个健康缺陷），8%的波动幅度大于 0.1 FI（5 个健康缺陷）。波动幅度随年龄和脆弱性水平的增加而增加，并且在女性、社会经济地位较低（教育程度较低）和随访期间死亡的个体中更高。
脆弱性指数波动是指老年人健康状况的不稳定性，代表了老年人脆弱性中一个迄今为止尚未被挖掘但相关的方面。未来对脆弱性波动的分析应该基于更多的重复观察，时间间隔更短。
