社区老年人衰弱的老年综合评估工具比较
Comparison of geriatric assessment tools for frailty among community elderly.
作者信息
Sukkriang Naparat, Punsawad Chuchard
机构信息
School of Medicine, Walailak University, Nakhon Si Thammarat, 80160 Thailand.
Walailak University Hospital, Nakhon Si Thammarat, 80160 Thailand.
出版信息
Heliyon. 2020 Sep 14;6(9):e04797. doi: 10.1016/j.heliyon.2020.e04797. eCollection 2020 Sep.
BACKGROUND
Frailty is an important condition in elderly individuals because it increases disability, morbidity, and mortality. The definition frailty from the Cardiovascular Health Study (CHS) criteria is used worldwide and defined as fulfilling 3 out of the 5 phenotypic criteria that indicate compromised energetics: weakness, slowness, low level of physical activity, self-reported exhaustion, and unintentional weight loss.
OBJECTIVE
This research aims to study the validity of 5 screening methods, e.g., Clinical Frailty Scale, simple FRAIL questionnaire, PRISMA-7 questionnaire, Time Up and Go Test (TUG), and Gérontopôle frailty screening tool (GFST), and compare those results with the definition of frailty by using the CHS criteria for screening frailty.
METHODS
We conducted a cross-sectional study. The sample was 214 elderly individuals, aged ≥60 years, and living in the community. We used 5 screening tests and the Fried phenotype (CHS criteria) as a reference standard. Analysis of the sensitivity, specificity, PPV, NPV, LR+, LR-, and accuracy of each screening was compared with the Fried phenotype (CHS criteria).
RESULTS
The prevalence of frailty of elderly individuals in the community was 11.7% when using the Fried phenotype (CHS criteria). The Clinical Frailty Scale has sensitivity 56%, specificity 98.41%, PPV 82.35%, NPV 94.42%, LR+ 35.28, LR- 0.45, and accuracy 93.46%. The simple FRAIL questionnaire has sensitivity 88%, specificity 85.71%, PPV 44.90%, NPV 98.18%, LR+ 6.61, LR- 0.14, and accuracy 85.98%. The PRISMA-7 questionnaire has sensitivity 76%, specificity 86.24%, PPV 42.22%, NPV 96.45%, LR+ 5.52, LR- 0.28, and accuracy 85.05%. TUG has sensitivity 72%, specificity 82.54%, PPV 35.29%, NPV 95.71%, LR+ 4.12, LR- 0.34, and accuracy 81.31%. The GFST has sensitivity 88%, specificity 83.56%, PPV 41.51%, NPV 98.14%, LR+ 5.37, LR- 0.14, and accuracy 84.11%.
CONCLUSIONS
The simple FRAIL questionnaire and GFST have the highest sensitivity compared with the CHS criteria. All screening tests in this study have an accuracy of more than 80% compared with the CHS criteria.
背景
衰弱是老年个体的一种重要状况，因为它会增加残疾、发病率和死亡率。心血管健康研究（CHS）标准对衰弱的定义在全球范围内被广泛使用，其定义为满足5个表型标准中的3个，这些标准表明能量代谢受损：虚弱、行动迟缓、体力活动水平低、自我报告的疲惫以及非故意体重减轻。
目的
本研究旨在探讨5种筛查方法的有效性，即临床衰弱量表、简易衰弱问卷、PRISMA - 7问卷、计时起立行走测试（TUG）和老年衰弱筛查工具（GFST），并将这些结果与使用CHS标准进行衰弱筛查的衰弱定义进行比较。
方法
我们进行了一项横断面研究。样本为214名年龄≥60岁且居住在社区的老年人。我们使用5种筛查测试，并将弗里德表型（CHS标准）作为参考标准。将每种筛查的敏感性、特异性、阳性预测值、阴性预测值、阳性似然比、阴性似然比和准确性与弗里德表型（CHS标准）进行比较。
结果
使用弗里德表型（CHS标准）时，社区老年人的衰弱患病率为11.7%。临床衰弱量表的敏感性为56%，特异性为98.41%，阳性预测值为82.35%，阴性预测值为94.42%，阳性似然比为35.28，阴性似然比为0.45，准确性为93.46%。简易衰弱问卷的敏感性为88%，特异性为85.71%，阳性预测值为44.90%，阴性预测值为98.18%，阳性似然比为6.61，阴性似然比为0.14，准确性为85.98%。PRISMA - 7问卷的敏感性为76%，特异性为86.24%，阳性预测值为42.22%，阴性预测值为96.45%，阳性似然比为5.52，阴性似然比为0.28，准确性为85.05%。TUG的敏感性为72%，特异性为82.54%，阳性预测值为35.29%，阴性预测值为95.71%，阳性似然比为4.12，阴性似然比为0.34，准确性为81.31%。GFST的敏感性为88%，特异性为83.56%，阳性预测值为41.51%，阴性预测值为98.14%，阳性似然比为5.37，阴性似然比为0.14，准确性为84.11%。
结论
与CHS标准相比，简易衰弱问卷和GFST具有最高的敏感性。本研究中的所有筛查测试与CHS标准相比，准确性均超过80%。
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