The Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, Massachusetts, USA.
Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
J Am Geriatr Soc. 2021 Mar;69(3):792-797. doi: 10.1111/jgs.16955. Epub 2020 Nov 25.
BACKGROUND/OBJECTIVES: Exploring deficit patterns among frail people may reveal subgroups of different prognostic importance.
Analysis of National Health and Aging Trends Study.
Community.
Community dwelling older adults with mild to moderate frailty (deficit-accumulation frailty index (FI) of 0.25-0.40) (n = 1821).
Latent class analysis identified distinct clinical subgroups based on comorbidity (range: 0-10), National Health and Aging Trends Study dementia classification, and short physical performance battery (SPPB) (range: 0-12). Survival analyses compared 5-year mortality by subgroups.
Three latent classes existed: Class 1 (n = 831, mean FI = 0.30) had 2.7% probable dementia, high comorbidities (mean = 3.6), and low physical impairment (SPPB mean = 9.9); Class 2 (n = 734, mean FI = 0.32) had 6.9% probable dementia, low comorbidities (mean = 2.8), and moderate physical impairment (SPPB mean = 6.2); Class 3 (n = 256, mean FI = 0.34) had 20.7% probable dementia, low comorbidities (mean = 2.4), and high physical impairment (SPPB mean = 2.0). Compared to Class 1, Classes 2 and 3 experienced higher 5-year mortality (C2: 1.28 (95% confidence intervals (CI) = 1.00-1.62); C3: 1.87 (95% CI = 1.29-2.73)).
Deficit patterns among the mild-to-moderately frail provide additional prognostic information and highlight opportunities for preventive interventions.
背景/目的：探索虚弱人群的缺陷模式可能揭示出不同预后重要性的亚组。
国家健康老龄化趋势研究的分析。
社区。
患有轻度至中度虚弱症的社区居住的老年人（缺陷累积虚弱指数（FI）为 0.25-0.40）（n=1821）。
潜在类别分析根据合并症（范围：0-10）、国家健康老龄化趋势研究痴呆分类和简短身体表现电池（SPPB）（范围：0-12）确定了不同的临床亚组。生存分析比较了亚组的 5 年死亡率。
存在三个潜在类别：第 1 类（n=831，平均 FI=0.30）有 2.7%的可能性患有痴呆症，合并症高（平均=3.6），身体损伤低（SPPB 平均=9.9）；第 2 类（n=734，平均 FI=0.32）有 6.9%的可能性患有痴呆症，合并症低（平均=2.8），身体损伤中等（SPPB 平均=6.2）；第 3 类（n=256，平均 FI=0.34）有 20.7%的可能性患有痴呆症，合并症低（平均=2.4），身体损伤高（SPPB 平均=2.0）。与第 1 类相比，第 2 类和第 3 类的 5 年死亡率更高（C2：1.28（95%置信区间（CI）=1.00-1.62）；C3：1.87（95% CI=1.29-2.73））。
轻度至中度虚弱人群的缺陷模式提供了额外的预后信息，并突出了预防干预的机会。
