Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan.
Geriatr Gerontol Int. 2019 Sep;19(9):896-901. doi: 10.1111/ggi.13740. Epub 2019 Jul 15.
Frailty and sarcopenia affect the prognosis and quality of life of patients with chronic obstructive pulmonary disease (COPD). However, it remains uncertain which model is the most suitable for evaluating vulnerability in patients with COPD. We evaluated the validity of three frailty models - the Kihon Checklist (KCL), the Japanese version of the Cardiovascular Health Study and the Study of Osteoporotic Fractures - and one sarcopenia model for older patients with COPD.
This cross-sectional study included 201 older (aged ≥65 years) outpatients with COPD. We used three frailty models and one sarcopenia model to identify their correlation with various indices that can evaluate the status of COPD and determine the most ideal model for evaluating vulnerability in patients with COPD.
The highest prevalence of frailty (38%) and lowest prevalence of robustness (26%) were observed using the KCL. Although all models reflected the characteristics of COPD, the KCL yielded the strongest correlations with clinically important physical, psychological and prognostic indices. The KCL yielded statistically significant differences in almost all indices among the three intergroup comparisons (robust, pre-frailty and frailty). The KCL was superior in extracting mood disorders to the other models.
Although all investigated models were useful, the KCL was the most suitable for evaluating the frailty status and might enable interventions in patients with COPD. Geriatr Gerontol Int 2019; 19: 896-901.
衰弱和肌少症影响慢性阻塞性肺疾病（COPD）患者的预后和生活质量。然而，目前尚不确定哪种模型最适合评估 COPD 患者的脆弱性。我们评估了三种衰弱模型（Kihon 检查表[KCL]、心血管健康研究的日本版本和骨质疏松性骨折研究）和一种用于老年 COPD 患者的肌少症模型的有效性。
这是一项横断面研究，纳入了 201 例年龄≥65 岁的 COPD 老年门诊患者。我们使用三种衰弱模型和一种肌少症模型来确定它们与可评估 COPD 状况的各种指标的相关性，并确定最适合评估 COPD 患者脆弱性的模型。
KCL 检测到的衰弱发生率最高（38%），稳健性发生率最低（26%）。虽然所有模型均反映了 COPD 的特征，但 KCL 与临床重要的生理、心理和预后指标相关性最强。在三组间比较中（稳健、衰弱前期和衰弱），KCL 在几乎所有指标上都有统计学显著差异。KCL 在提取情绪障碍方面优于其他模型。
尽管所有研究的模型都很有用，但 KCL 是评估衰弱状态最适合的模型，可能有助于对 COPD 患者进行干预。老年医学与老年病学杂志 2019；19：896-901。
