Redín-Sagredo M J, Aldaz Herce P, Casas Herrero A, Gutiérrez-Valencia M, Martínez-Velilla N
Centro de Salud de San Juan. Servicio Navarro de Salud. Pamplona..
An Sist Sanit Navar. 2019 Aug 23;42(2):169-178. doi: 10.23938/ASSN.0642.
Frailty means a state of vulnerability with a predisposition to adverse health outcomes, closely related to age and a consequent loss of functional capability. Early detection is important for initiating measures to slow its progression. Primary Health Care (PHC) occupies a privileged place in this. However, we do not possess a gold standard tool for its detection. Our aim is to analyse the prevalence of frailty in PHC and define the most useful diagnostic tool for this area.
Cross-sectional study with 225 people were selected from a population of 4,252 people aged over 75 years-old, from three different basic health zones of Navarre. Four different diagnostic tests for frailty were conducted: the Fried phenotype, the Short Physical Performance Battery (SPPB), the Timed Up-to-Go test (TUG) and the Gait Speed test (GS). Patients who were unable to finish any of the tests weren't included in the subsequent analysis.
Fifty-one percent of participants were men, with mean age 80.5 years-old, 80% were taking more than five daily drugs, 8.4% had cognitive impairment, and 31.1 and 41.3% were independent for basic and instrumental activities, respectively, of daily living. The frailty prevalence was 8.3% for Fried phenotype, 13.7% for SPPB, 46.2% for TUG and 52.2% for Gait Speed.
Great heterogeneity in the prevalence of frailty was shown depending on the tool employed. As a reliable, fast and simple tool for early detection of frailty is needed in PHC, based on our results and the particularities of PHC, we propose TUG or GS as good early predictors of this decline.
衰弱是指一种易发生不良健康后果的脆弱状态，与年龄密切相关，并随之出现功能能力丧失。早期检测对于启动减缓其进展的措施很重要。初级卫生保健（PHC）在这方面具有特殊地位。然而，我们没有用于检测衰弱的金标准工具。我们的目的是分析初级卫生保健中衰弱的患病率，并确定该领域最有用的诊断工具。
从纳瓦拉三个不同基本卫生区的4252名75岁以上人群中选取225人进行横断面研究。对衰弱进行了四种不同的诊断测试：弗里德表型、简短体能测试电池（SPPB）、计时起立行走测试（TUG）和步速测试（GS）。无法完成任何一项测试的患者未纳入后续分析。
51%的参与者为男性，平均年龄80.5岁，80%的人每天服用五种以上药物，8.4%的人有认知障碍，31.1%和4l.3%的人分别在基本日常生活活动和工具性日常生活活动方面具有自理能力。弗里德表型的衰弱患病率为8.3%，SPPB为13.7%，TUG为46.2%，步速测试为52.2%。
根据所采用的工具不同，衰弱患病率显示出很大的异质性。由于初级卫生保健需要一种可靠、快速且简单的早期衰弱检测工具，基于我们的研究结果和初级卫生保健的特点，我们建议TUG或步速测试作为这种功能下降的良好早期预测指标。
