Ožić Sanja, Vasiljev Vanja, Ivković Vanja, Bilajac Lovorka, Rukavina Tomislav
Zagreb Holding, City of Zagreb.
Department of Social Medicine and Epidemiology, Faculty of Medicine.
Medicine (Baltimore). 2020 Feb;99(8):e19145. doi: 10.1097/MD.0000000000019145.
Frailty is a pronounced symptom of aging associated with multiple comorbid states and adverse outcomes. The aim of this study was to evaluate the impact of 2 interventions, one based on prevention of falls and the other on prevention of loneliness, on total frailty and dimensions of frailty in urban community-dwelling elderly as well as associations with independent living.This prospective interventional study followed up 410 persons aged 75 to 95. The participants of the control and intervention groups were monitored through a public health intervention programme. The level of frailty was measured by the Tilburg Frailty Indicator (TFI) questionnaire and the factors of independent living were analyzed using validated questionnaires.After 1 year, physical frailty measured in the control group showed a statistically significant increase (r = -0.11), while in the intervention groups physical frailty did not increase (both P > .05). Psychological frailty measured after 1 year in the control group was significantly higher (r = -0.19), as well as in the group where the public health interventions to reduce loneliness were carried out (r = -0.19). Psychological frailty did not increase in the group in which public health interventions to prevent falls were carried out, and social frailty did not increase at all in the study period. The total level of frailty in the control group after 1 year was significantly increased (r = -0.19), while no increase was seen in the overall frailty in the intervention group. Multivariate analysis has shown that both interventions where independently associated with lower end frailty. Additionally, higher baseline frailty and visit to a physician in the last year were positively associated with higher end-study frailty level, while higher number of subjects in the household and higher total psychological quality of life (SF-12) were independently associated with lower end-study frailty. Only in the prevention of falls group there was no increase in restriction in the activities of daily living throughout study follow-up.Public health interventions to prevent falls and to prevent loneliness have a positive effect on the frailty and independent living of the elderly living in their own homes in an urban community.
衰弱是与多种共病状态及不良后果相关的一种明显的衰老症状。本研究的目的是评估两种干预措施的影响，一种基于预防跌倒，另一种基于预防孤独，对城市社区居家老年人的总体衰弱及衰弱维度的影响，以及与独立生活的关联。这项前瞻性干预研究对410名75至95岁的人员进行了随访。对照组和干预组的参与者通过公共卫生干预项目进行监测。衰弱程度通过蒂尔堡衰弱指标（TFI）问卷进行测量，独立生活因素使用经过验证的问卷进行分析。1年后，对照组测量的身体衰弱显示出有统计学意义的增加（r = -0.11），而干预组的身体衰弱没有增加（两者P > 0.05）。对照组1年后测量的心理衰弱显著更高（r = -0.19），在实施减少孤独的公共卫生干预措施的组中也是如此（r = -0.19）。在实施预防跌倒的公共卫生干预措施的组中，心理衰弱没有增加，在研究期间社会衰弱根本没有增加。1年后对照组的总体衰弱水平显著增加（r = -0.19），而干预组的总体衰弱没有增加。多变量分析表明，两种干预措施均与较低的末期衰弱独立相关。此外，较高的基线衰弱程度和去年看医生与较高的研究末期衰弱水平呈正相关，而家庭中较多的人数和较高的总体心理生活质量（SF - 12）与较低的研究末期衰弱独立相关。仅在预防跌倒组中，在整个研究随访期间日常生活活动受限情况没有增加。预防跌倒和预防孤独的公共卫生干预措施对城市社区居家老年人的衰弱和独立生活有积极影响。
