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[老年人的衰弱与全科医疗中的身体活动:一项前瞻性研究]

[Frailty of the elderly and physical activity in general practice: A prospective study].

作者信息

Zulfiqar A-A, Lorenzo-Villalba N, Peixoto A, Rio J, Gillibert A

机构信息

Geriatric Department, Saint-Julien Hospital, CHU de Rouen, 76000 Rouen, France.

Internal medicine department, Hôpital civil, CHRU Strasbourg, 67000 Strasbourg, France.

出版信息

Rev Epidemiol Sante Publique. 2020 Sep;68(5):282-287. doi: 10.1016/j.respe.2020.06.006. Epub 2020 Aug 24.

Abstract

INTRODUCTION

Frailty is a transient and reversible condition that can lead to significant morbidity and mortality and to the loss of autonomy. It is one of the key issues in public health and the prevention of addiction. Physical activity is often described as a protective factor against addiction and as a factor in limiting frailty. Our goal is to analyze the relationship between physical activity and frailty among the elderly METHODS: A cross-sectional observational study was carried out in three general practice clinics located in the French department of Eure. Patients aged 65 and over were included during a consultation with their GP. Dependent patients under the ADL scale were excluded. Level of physical activity was assessed by the Ricci and Gagnon questionnaire, which defines an active profile as a score≥18 points. Frailty was sought out by the Fried scale and the SEGA A grid. Multivariate analysis was performed to adjust frailty scores to age, gender, and level of physical activity.

RESULTS

Out of the 70 patients included, 36 were active (51%) and 34 inactive (49%). They were predominantly female with 47 women (67%). Average age was 75.3years. Twelve patients were diagnosed as frail (17%) with the Fried scale and 24 (34%) with the SEGA A grid. Bivariate analysis revealed a greater frailty according to the Fried criteria in the inactive than in the active patients (mean for active patients 0.56 IC95 [0.31; 0.80], compared to 1.76 [1.21; 2.32] in the inactive patients, p<0.0001). The difference in mean was likewise significant regarding the SEGA A score (6.42 IC95 [5.34, 7.49] in the active population, as opposed to 8.65 IC95 [7.15, 10.15] among the inactive, p=0.017). In multivariate analysis, the Fried scale was primarily influenced by age and ADL, while the SEGA score was impacted by female gender and level of physical activity.

CONCLUSION

Physical activity seems to have a positive effect on frailty. It would be interesting to propose systematic screening for frailty in general medicine and to institute preventive measures, including physical activity. Initiatives encouraging and promoting seniors' physical activity should be strengthened.

摘要

引言

虚弱是一种短暂且可逆的状态,可能导致严重的发病和死亡以及自主性丧失。它是公共卫生和预防成瘾的关键问题之一。体育活动常被描述为预防成瘾的保护因素以及限制虚弱的一个因素。我们的目标是分析老年人体育活动与虚弱之间的关系。方法:在法国厄尔省的三家普通诊所进行了一项横断面观察性研究。65岁及以上的患者在与他们的全科医生会诊期间被纳入。ADL量表下的依赖患者被排除。体育活动水平通过里奇和加尼翁问卷进行评估,该问卷将活跃状态定义为得分≥18分。通过弗里德量表和SEGA A网格来查找虚弱情况。进行多变量分析以将虚弱得分调整为年龄、性别和体育活动水平。

结果

在纳入的70名患者中,36名活跃(51%),34名不活跃(49%)。他们主要为女性,有47名女性(67%)。平均年龄为75.3岁。根据弗里德量表,12名患者被诊断为虚弱(17%),根据SEGA A网格,24名患者被诊断为虚弱(34%)。双变量分析显示,根据弗里德标准,不活跃患者比活跃患者更虚弱(活跃患者平均值为0.56,95%置信区间[0.31;0.80],不活跃患者为1.76[1.21;2.32],p<0.0001)。关于SEGA A评分,平均值差异同样显著(活跃人群中为6.42,95%置信区间[5.34,7.49],不活跃人群中为8.65,95%置信区间[7.15,10.15],p = 0.017)。在多变量分析中,弗里德量表主要受年龄和ADL影响,而SEGA评分受女性性别和体育活动水平影响。

结论

体育活动似乎对虚弱有积极影响。在普通医学中提议进行系统的虚弱筛查并制定包括体育活动在内的预防措施将会很有意义。应加强鼓励和促进老年人体育活动的举措。

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