Department of Palliative Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland.
Faculty of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland.
Int J Environ Res Public Health. 2020 Nov 21;17(22):8656. doi: 10.3390/ijerph17228656.
To identify the interrelations among determinants of multidimensional frailty, physical frailty, and their individual components. A group of 1024 community-dwelling people older than 65 years completed questionnaires regarding: multidimensional frailty (Tilburg Frailty Indicator, TFI) and physical frailty (FRAIL scale), and common frailty risk factors. Multidimensional frailty was recognized in 559 subjects (54.6%) and determined by 13 factors (R = 0.21 in logistic regression). After incorporating TFI components to the models, the majority of previous risk factors became non-essential, and the frailty deficits mainly determined each other with R ranging between 0.07-0.67. Physical frailty and non-robust status (i.e., either physical frailty or pre-frailty) were recognized in 64 (6.3%) and 542 (52.9%) participants, and were determined by 5 factors (R = 0.33) and 11 factors (R = 0.34), respectively. Associations between the frailty deficits were detected within and between different dimensions (i.e., physical, psychological and social); the physical domain was mainly related to the psychological one which in turn was additionally associated with the social one. Frailty is the accumulation of deficits and is determined by factors other than the determinants of the individual deficits. The associations between deficits coming from various dimensions of human functioning presumably amplify their effects and accelerate frailty development.
为了确定多维脆弱性、身体脆弱性及其各个组成部分的决定因素之间的相互关系。一组 1024 名居住在社区的 65 岁以上的人完成了关于多维脆弱性(蒂尔堡脆弱性指标,TFI)和身体脆弱性(脆弱性量表)以及常见脆弱性风险因素的问卷。在 559 名受试者(54.6%)中识别出多维脆弱性,并由 13 个因素决定(逻辑回归中的 R = 0.21)。在将 TFI 成分纳入模型后,大多数先前的风险因素变得不重要,并且脆弱性缺陷主要通过 R 值在 0.07-0.67 之间相互决定。64 名(6.3%)和 542 名(52.9%)参与者分别识别出身体脆弱性和非健壮状态(即身体脆弱性或虚弱前状态),并由 5 个因素(R = 0.33)和 11 个因素(R = 0.34)决定。在不同维度(即身体、心理和社会)内和之间检测到脆弱性缺陷之间的关联;身体领域主要与心理领域相关,而心理领域又与社会领域相关。脆弱性是缺陷的积累,是由个体缺陷的决定因素以外的因素决定的。来自人类功能各个维度的缺陷之间的关联可能会放大它们的影响并加速脆弱性的发展。