Xujiao Chen. Department of Geriatrics, Zhejiang Hospital, Lingyin Road #12, Hangzhou 310013, People's Republic of China, Tel +86 18069897567, Fax +86 0571 87985100, Email
J Nutr Health Aging. 2021;25(1):77-83. doi: 10.1007/s12603-020-1455-8.
This study aimed to assess the feasibility of the Clinical Frailty Scale (CFS) and clinical biomarkers in assessing the frailty in elder inpatients in China.
The study was a cross-sectional study.
The study included 642 elder inpatients (295 females and 347 males) aged ≥65 years, from the Department of Geriatrics of Zhejiang Hospital between January 2018 and December 2019.
All participants underwent a comprehensive geriatric assessment and blood tests. Univariate and multivariate logistic regression was used to analyze the association between risk factors and frailty.
The average age of the participants was 82.72±8.06 years (range: 65-95 years) and the prevalence of frailty was 39.1% according to the CFS. Frail participants showed significantly lower short physical performance battery (SPPB), basic activities of daily living (ADL) and instrumental activities of daily living (IADL) scores (all p<0.001), and lower hemoglobin, total protein and albumin levels (all P<0.05) than nonfrail participants. Frail participants had higher CRP, D-dimer and fibrinogen levels than nonfrail participants (all p<0.05). Univariate logistic regression analysis showed a significant association between frailty and age, comorbidity, polypharmacy, fall history, SPPB, ADL, and IADL scores, D-dimer, fibrinogen, hemoglobin, total protein and albumin levels (all P<0.05). Multivariate logistic regression analysis indicated that age (odds ratio (OR), 95% confidence interval (CI)= 1.151(1.042-1.272), P=0.006), SPPB scores (OR, 95% CI=0.901(0.601-1.350), P<0.001), and D-dimer (OR, 95% CI=4.857(2.182-6.983), P<0.001), fibrinogen (OR, 95% CI=2.665(0.977-4.254), P<0.001), hemoglobin (OR, 95% CI=0.837(0.725-0.963), P= 0.044), and albumin (OR, 95% CI=0.860 (0.776-1.188), P<0.001) levels were independently associated with frailty in all participants.
Frailty in elder inpatients in China is characterized by older age, a lower SPPB scores, higher D-dimer and fibrinogen levels and lower hemoglobin and albumin levels. Functional decline and malnutrition may be the targets of frailty interventions.
本研究旨在评估临床虚弱量表（CFS）和临床生物标志物在中国老年住院患者中评估虚弱的可行性。
这是一项横断面研究。
该研究纳入了 2018 年 1 月至 2019 年 12 月期间来自浙江医院老年科的 642 名年龄≥65 岁的老年住院患者（女性 295 名，男性 347 名）。
所有参与者均接受了全面的老年评估和血液检查。采用单因素和多因素逻辑回归分析危险因素与虚弱之间的关联。
参与者的平均年龄为 82.72±8.06 岁（范围：65-95 岁），根据 CFS，虚弱的患病率为 39.1%。虚弱的参与者在短体适能表现测试（SPPB）、基本日常生活活动（ADL）和工具性日常生活活动（IADL）评分上明显较低（均 p<0.001），且血红蛋白、总蛋白和白蛋白水平较低（均 P<0.05）。与非虚弱的参与者相比，虚弱的参与者 C 反应蛋白（CRP）、D-二聚体和纤维蛋白原水平较高（均 p<0.05）。单因素逻辑回归分析显示，虚弱与年龄、合并症、多种药物治疗、跌倒史、SPPB、ADL 和 IADL 评分、D-二聚体、纤维蛋白原、血红蛋白、总蛋白和白蛋白水平显著相关（均 P<0.05）。多因素逻辑回归分析表明，年龄（比值比（OR），95%置信区间（CI）=1.151（1.042-1.272），P=0.006）、SPPB 评分（OR，95% CI=0.901（0.601-1.350），P<0.001）和 D-二聚体（OR，95% CI=4.857（2.182-6.983），P<0.001）、纤维蛋白原（OR，95% CI=2.665（0.977-4.254），P<0.001）、血红蛋白（OR，95% CI=0.837（0.725-0.963），P=0.044）和白蛋白（OR，95% CI=0.860（0.776-1.188），P<0.001）水平与所有参与者的虚弱状况独立相关。
中国老年住院患者的虚弱特征为年龄较大、SPPB 评分较低、D-二聚体和纤维蛋白原水平较高以及血红蛋白和白蛋白水平较低。功能下降和营养不良可能是虚弱干预的目标。
