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三种虚弱量表预测老年人不良结局的比较:一项前瞻性队列研究。

Comparison of Three Frailty Scales for Prediction of Adverse Outcomes among Older Adults: A Prospective Cohort Study.

机构信息

Xiao hong Liu, No. 1 Shuai fu yuan, Dong cheng District, Beijing, 100730, China, e-mail:

出版信息

J Nutr Health Aging. 2021;25(4):419-424. doi: 10.1007/s12603-020-1534-x.


DOI:10.1007/s12603-020-1534-x
PMID:33786557
Abstract

OBJECTIVES: To compare the ability of Frailty Phenotype (FP), FRAIL and Frailty Index (FI) to predict adverse outcomes. DESIGN: A prospective cohort study. SETTING: A senior community in Beijing, China. PARTICIPANTS: A total of 188 older adults aged 65 years or older (mean age 84.0 ± 4.4 years, 58.5% female). MEASUREMENTS: Frailty was evaluated by FP, FRAIL and FI. The agreement between scales was assessed by Cohen kappa coefficient. The predictive value of the three scales for adverse outcomes during one-year follow-up period were analyzed using decision curve analysis(DCA) and receiver operating characteristic curve (ROC) analysis. RESULTS: Frailty ranged from 25% (FRAIL) to 42.6% (FI). The agreement between scales was moderate to good (Cohen's kappa coefficient 0.44~0.61). DCA showed though the curves of the scales overlapped across all relevant risk thresholds, clinical treating had a higher net benefit than "treat all" and "treat none" when risk of unplanned hospital visits ≥30%, risk of functional decline or falls ≥15%. The three scales had similar predictive value for unplanned hospital visits (area under ROC, AUC 0.63, 0.64 and 0.69). FRAIL and FI had similar predictive value for functional decline (AUC 0.63,0.65). FI had predictive value for falls (AUC 0.65). CONCLUSIONS: All three scales showed clinical utility but FRAIL may be best in practice because it is simple. Multidimensional measures of frailty are better than unidimensional for prediction of adverse outcomes among older adults.

摘要

目的:比较衰弱表型(FP)、衰弱评估工具(FRAIL)和衰弱指数(FI)预测不良结局的能力。 设计:前瞻性队列研究。 地点:中国北京的一个高级社区。 参与者:共纳入 188 名 65 岁及以上的老年人(平均年龄 84.0±4.4 岁,58.5%为女性)。 测量方法:采用 FP、FRAIL 和 FI 评估衰弱。采用 Cohen κ 系数评估量表间的一致性。采用决策曲线分析(DCA)和受试者工作特征曲线(ROC)分析评估三种量表在一年随访期间预测不良结局的价值。 结果:衰弱的发生率为 25%(FRAIL)至 42.6%(FI)。量表间的一致性为中等至良好(Cohen κ 系数 0.44~0.61)。DCA 显示,虽然曲线在所有相关风险阈值上都有重叠,但当非计划性就诊风险≥30%、功能下降或跌倒风险≥15%时,临床治疗比“治疗所有”和“不治疗所有”具有更高的净获益。三种量表对非计划性就诊的预测价值相似(ROC 曲线下面积,AUC 为 0.63、0.64 和 0.69)。FRAIL 和 FI 对功能下降的预测价值相似(AUC 为 0.63、0.65)。FI 对跌倒的预测价值较高(AUC 为 0.65)。 结论:三种量表均具有临床应用价值,但 FRAIL 可能在实践中最佳,因为它简单。多维衰弱指标比单一维度指标更能预测老年人的不良结局。

相似文献

[1]
Comparison of Three Frailty Scales for Prediction of Adverse Outcomes among Older Adults: A Prospective Cohort Study.

J Nutr Health Aging. 2021

[2]
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J Am Geriatr Soc. 2013-8-26

[3]
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[4]
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[5]
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[6]
Accessing the discriminatory performance of FRAIL-NH in two-class and three-class frailty and examining its agreement with the frailty index among nursing home residents in mainland China.

BMC Geriatr. 2019-10-30

[7]
The prevalence and health consequences of frailty in a population-based older home care cohort: a comparison of different measures.

BMC Geriatr. 2016-7-7

[8]
A comparison of Frailty Indexes Based on a Comprehensive Geriatric Assessment for the Prediction of Adverse Outcomes.

J Nutr Health Aging. 2016

[9]
Predictive Accuracy of Frailty Tools for Adverse Outcomes in a Cohort of Adults 80 Years and Older: A Decision Curve Analysis.

J Am Med Dir Assoc. 2020-3

[10]
Predictive validity of two frailty tools for mortality in Chinese nursing home residents: frailty index based on common laboratory tests (FI-Lab) versus FRAIL-NH.

Aging Clin Exp Res. 2018-9-26

引用本文的文献

[1]
Comparative Analysis of Three Frailty Assessment Tools: A Cross-Sectional Study.

Inquiry. 2025

[2]
Effects of 12-Week Dietary Inflammatory Index-Based Dietary Education on Frailty Status in Frail Patients with Colorectal Cancer: A Randomized Controlled Trial.

Nutrients. 2025-7-1

[3]
Metformin reduces the risk of frailty: evidence from a Mendelian randomization study.

Diabetol Metab Syndr. 2025-6-23

[4]
Screening for frailty and its association with activities of daily living, cognitive impairment, and falls among community-dwelling older adults in China.

BMC Geriatr. 2024-7-3

[5]
Genetic and phenotypic associations of frailty with cardiovascular indicators and behavioral characteristics.

J Adv Res. 2025-5

[6]
Association of frailty index with congestive heart failure, all-cause and cardiovascular mortality among individuals with type 2 diabetes: a study from National Health and Nutrition Examination Surveys (NHANES), 1999-2018.

Diabetol Metab Syndr. 2023-10-24

[7]
Prevalence of Frailty Among Chinese Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis.

Int J Public Health. 2023

[8]
Association of sleep duration and physical frailty with cognitive function in older patients with coexisting atrial fibrillation and heart failure.

Nurs Open. 2023-5

[9]
Comparison of three frailty screening instruments for prediction of adverse outcomes among older adults in the emergency department.

Geriatr Gerontol Int. 2022-10

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