Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Aging and Health Research Center, National Yang Ming University, New Taipei City, Taiwan; Department of Geriatric Medicine, National Yang Ming University School of Medicine, New Taipei City, Taiwan.
Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan; Aging and Health Research Center, National Yang Ming University, New Taipei City, Taiwan; Department of Geriatric Medicine, National Yang Ming University School of Medicine, New Taipei City, Taiwan.
Arch Gerontol Geriatr. 2020 Mar-Apr;87:103986. doi: 10.1016/j.archger.2019.103986. Epub 2019 Nov 18.
Frailty is a well-known geriatric syndrome with strong adverse health impact to older people. The socio-economic status and the accessibility of health services in rural communities may increase the risk of frailty. We conducted a cross-sectional study in rural districts of New Taipei City, Taiwan, to explore the epidemiology and associated factors of frailty. Data of 1014 participants (mean age: 78.7 ± 8.0 years, 66.3 % females) were obtained with the prevalence of frailty and pre-frailty 17.6 % and 23.1 %, respectively. The mean Barthel Index was 98.5 ± 5.8, and their mean Instrumental Activities of Daily Living (IADL) were 7.2 ± 1.5. Frail older people tended perform worse in timed up-and-go tests (24.7 % in frailty and 0.4 % in robust). The mean mini-mental state examination (MMSE) score for all participants was 23.3 ± 5.1, but was lower in frail older for around 5 points. Depressive symptoms were more common in frail older persons than robust ones (31.5 % vs 14.3 %), which was similar in the nutritional status. Results of the logistic regression showed that better education, IADL and MMSE scores were protective factors against frailty. The presence of depressive symptoms, urinary incontinence, abnormal performance of TUG, and the presence of the risk for malnutrition were all independent assciated factors for frailty. In conclusion, the prevalence of frailty was higher among older adults living in rural communities that deserves specific public health attentions. Further intervention study covering special needs in rural communities is needed to promote health of older people.
衰弱是一种广为人知的老年综合征，对老年人的健康有严重的不良影响。农村社区的社会经济地位和卫生服务的可及性可能会增加衰弱的风险。我们在台湾新北市的农村地区进行了一项横断面研究，以探讨衰弱的流行病学和相关因素。共获得 1014 名参与者的数据（平均年龄：78.7±8.0 岁，66.3%为女性），衰弱和衰弱前期的患病率分别为 17.6%和 23.1%。平均巴氏量表评分为 98.5±5.8，平均工具性日常生活活动量表（IADL）评分为 7.2±1.5。虚弱的老年人在计时起立行走测试中表现更差（虚弱者中 24.7%，健壮者中 0.4%）。所有参与者的平均简易精神状态检查（MMSE）评分为 23.3±5.1，但虚弱者的评分约低 5 分。虚弱的老年人比健壮的老年人更容易出现抑郁症状（31.5%比 14.3%），营养状况也类似。逻辑回归的结果表明，较高的教育程度、IADL 和 MMSE 评分是衰弱的保护因素。抑郁症状、尿失禁、TUG 异常表现和营养不良风险的存在都是衰弱的独立相关因素。总之，农村社区老年人的衰弱患病率较高，值得特别关注公共卫生。需要进一步开展针对农村社区特殊需求的干预研究，以促进老年人的健康。
