Panhwar Yasmeen Naz, Naghdy Fazel, Naghdy Golshah, Stirling David, Potter Janette
University of Wollongong, Wollongong, Australia.
Illawarra Health and Medical Research Institute, Wollongong, Australia.
BMC Biomed Eng. 2019 Mar 18;1:7. doi: 10.1186/s42490-019-0007-y. eCollection 2019.
Frailty assessment is a critical approach in assessing the health status of older people. The clinical tools deployed by geriatricians to assess frailty can be grouped into two categories; using a questionnaire-based method or analyzing the physical performance of the subject. In performance analysis, the time taken by a subject to complete a physical task such as walking over a specific distance, typically three meters, is measured. The questionnaire-based method is subjective, and the time-based performance analysis does not necessarily identify the kinematic characteristics of motion and their root causes. However, kinematic characteristics are crucial in measuring the degree of frailty.
The studies reviewed in this paper indicate that the quantitative analysis of activity of daily living, balance and gait are significant methods for assessing frailty in older people. Kinematic parameters (such as gait speed) and sensor-derived parameters are also strong markers of frailty. Seventeen gait parameters are found to be sensitive for discriminating various frailty levels. Gait velocity is the most significant parameter. Short term monitoring of daily activities is a more significant method for frailty assessment than is long term monitoring and can be implemented easily using clinical tests such as sit to stand or stand to sit. The risk of fall can be considered an outcome of frailty.
Frailty is a multi-dimensional phenomenon that is defined by various domains; physical, social, psychological and environmental. The physical domain has proven to be essential in the objective determination of the degree of frailty in older people. The deployment of inertial sensor in clinical tests is an effective method for the objective assessment of frailty.
衰弱评估是评估老年人健康状况的关键方法。老年医学专家用于评估衰弱的临床工具可分为两类：使用基于问卷的方法或分析受试者的身体表现。在身体表现分析中，会测量受试者完成诸如走过特定距离（通常为三米）等身体任务所需的时间。基于问卷的方法具有主观性，而基于时间的身体表现分析不一定能识别运动的运动学特征及其根本原因。然而，运动学特征在测量衰弱程度方面至关重要。
本文综述的研究表明，对日常生活活动、平衡和步态进行定量分析是评估老年人衰弱的重要方法。运动学参数（如步态速度）和传感器衍生参数也是衰弱的有力标志物。发现有十七个步态参数对区分不同的衰弱水平敏感。步态速度是最重要的参数。与长期监测相比，短期监测日常活动是一种更重要的衰弱评估方法，并且可以通过诸如坐立或站立坐立等临床测试轻松实现。跌倒风险可被视为衰弱的一个结果。
衰弱是一种多维现象，由身体、社会、心理和环境等各个领域定义。事实证明，身体领域在客观确定老年人的衰弱程度方面至关重要。在临床测试中部署惯性传感器是客观评估衰弱的有效方法。
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