Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands,
Department of General Practice & Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Gerontology. 2021;67(1):69-77. doi: 10.1159/000512049. Epub 2021 Jan 11.
Frailty can be seen as a continuum, from fit to frail. While many recent studies have focused on frailty, much less attention has been paid to the other end of the continuum: the group of older adults that remain (relatively) vital. Moreover, there is a lack of studies on frailty and vitality that investigate predictors from multiple domains of functioning simultaneously. The aim of this study was to identify predictors of frailty as well as vitality among older adults aged 75 years and over.
We used longitudinal data from 569 adults aged ≥75 years who participated in the Longitudinal Aging Study Amsterdam. Predictors from the sociodemographic, social, psychological, lifestyle, and physical domains of functioning were measured at T1 (2008-2009). We used the frailty index (FI) to identify frail (FI ≥ 0.25) and vital (FI ≤ 0.15) respondents at follow-up, 3 years later (T2: 2011-2012). We conducted logistic regression analyses with backward stepwise selection to develop and internally validate our prediction models.
The prevalence of frailty in our sample at follow-up was 49.4% and the prevalence of vitality was 18.3%. Predictors of frailty and vitality partly overlapped and included age, depressive symptoms, number of chronic diseases, and self-rated health. We also found predictors that did not overlap. Male sex, moderate alcohol use, more emotional support received, and no hearing problems, were predictors of vitality. Lower cognitive functioning, polypharmacy, and pain were predictors of frailty. The final model for vitality explained 42% of the variance and the final model for frailty explained 48%. Both models had a good discriminative value (area under ROC-curve [AUC] vitality: 0.88; AUC frailty: 0.85).
Among older adults aged 75 years and over, predictors of frailty only partially overlap with predictors of vitality. The readily accessible predictors in our models may help to identify older adults who are likely to be vital, or who are at risk of frailty.
衰弱可以被视为一个连续体，从健康到衰弱。虽然最近有许多研究关注衰弱，但对连续体的另一端——相对健康的老年人关注较少。此外，缺乏同时研究多个功能领域的衰弱和活力的预测因素的研究。本研究旨在确定 75 岁及以上老年人衰弱和活力的预测因素。
我们使用来自 569 名年龄≥75 岁的成年人的纵向数据，他们参加了阿姆斯特丹纵向老龄化研究。在 T1（2008-2009 年）测量了来自社会人口学、社会、心理、生活方式和身体功能领域的预测因素。我们使用衰弱指数（FI）在 3 年后的随访中（T2：2011-2012 年）识别衰弱（FI≥0.25）和健康（FI≤0.15）的受访者。我们使用向后逐步选择的逻辑回归分析来开发和内部验证我们的预测模型。
在我们的样本中，随访时衰弱的患病率为 49.4%，活力的患病率为 18.3%。衰弱和活力的预测因素部分重叠，包括年龄、抑郁症状、慢性疾病数量和自我报告的健康状况。我们还发现了不重叠的预测因素。男性、适度饮酒、获得更多情感支持和没有听力问题是活力的预测因素。较低的认知功能、多药治疗和疼痛是衰弱的预测因素。活力的最终模型解释了 42%的方差，衰弱的最终模型解释了 48%的方差。两个模型都具有良好的判别价值（ROC 曲线下面积[活力 AUC]：0.88；衰弱 AUC：0.85）。
在 75 岁及以上的老年人中，衰弱的预测因素与活力的预测因素仅部分重叠。我们模型中易于获得的预测因素可能有助于识别可能健康或处于衰弱风险的老年人。
