日本2019冠状病毒病应对措施影响下社区居住老年人的实际衰弱状况和生活方式变化：一项横断面研究
Actual Frailty Conditions and Lifestyle Changes in Community-Dwelling Older Adults Affected by Coronavirus Disease 2019 Countermeasures in Japan: A Cross-Sectional Study.
作者信息
Shinohara Tomoyuki, Saida Kosuke, Tanaka Shigeya, Murayama Akihiko
机构信息
Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki-shi, Japan.
Department of Physical Therapy, Faculty of Rehabilitation, Gunma University of Health and Welfare, Maebashi-shi, Japan.
出版信息
SAGE Open Nurs. 2021 Jun 24;7:23779608211025117. doi: 10.1177/23779608211025117. eCollection 2021 Jan-Dec.
INTRODUCTION
Because of the countermeasures to prevent the spread of coronavirus disease 2019 (COVID-19) in Japan, it is easy to predict that the suspension of local activities and changes in lifestyle that lead to decreased activity will result in increased frailty and prefrailty rates in older adults.
OBJECTIVE
To clarify the actual frailty conditions and lifestyle changes among community-dwelling older adults affected by COVID-19 countermeasures in Japan.
METHODS
This cross-sectional study was conducted between May 8 and June 12, 2020. Self-reported questionnaires were distributed to 1,078 older adults aged ≥65 years. We used the frailty screening index to assess frailty status and developed the Questionnaire for Change of Life (QCL) to assess lifestyle changes, the amount of daily movement, leg muscle strength, meal size, worry or anxiety, and opportunities to talk to people. The differences in prevalence rates of frailty, prefrailty, and robustness between this study and the reference based on the Japanese meta-analysis were verified using the chi-square goodness of fit test. We compared each of the QCL results among the frailty, prefrailty, and robust groups using Fisher's exact test.
RESULTS
Of 680 older adults (63.1%) analyzed, 60 (8.8%) had frailty and 354 (52.1%) had prefrailty. There was a significant difference between the observed and expected prevalence based on the reference (p = 0.018). The frailty status was significantly associated with lifestyle changes. In participants with frailty, the amount of daily movement, leg muscle strength, and meal size significantly decreased (p < 0.001), whereas worry or anxiety significantly increased (p = 0.040). In contrast, regardless of the frailty status, opportunities to talk to people decreased.
CONCLUSION
The prevalence of frailty and prefrailty might have increased due to the effects of COVID-19 countermeasures. Moreover, the lifestyle of community-dwelling older adults affected by COVID-19 countermeasures has changed. Lifestyle changes were more pronounced among older adults with frailty.
引言
由于日本采取了预防2019冠状病毒病（COVID-19）传播的对策，很容易预测到当地活动的暂停以及导致活动减少的生活方式改变将导致老年人虚弱和衰弱前期发生率增加。
目的
阐明日本受COVID-19对策影响的社区居住老年人的实际虚弱状况和生活方式变化。
方法
本横断面研究于2020年5月8日至6月12日进行。向1078名年龄≥65岁的老年人发放了自我报告问卷。我们使用虚弱筛查指数评估虚弱状态，并编制了生活变化问卷（QCL）来评估生活方式变化、每日运动量、腿部肌肉力量、进餐量、担忧或焦虑以及与人交谈的机会。使用卡方拟合优度检验验证了本研究与基于日本荟萃分析的参考数据之间虚弱、衰弱前期和强健状态患病率的差异。我们使用Fisher精确检验比较了虚弱、衰弱前期和强健组之间的每个QCL结果。
结果
在分析的680名老年人（63.1%）中，60人（8.8%）有虚弱，354人（52.1%）有衰弱前期。观察到的患病率与基于参考数据的预期患病率之间存在显著差异（p = 0.018）。虚弱状态与生活方式变化显著相关。在虚弱的参与者中，每日运动量、腿部肌肉力量和进餐量显著下降（p < 0.001），而担忧或焦虑显著增加（p = 0.040）。相比之下，无论虚弱状态如何，与人交谈的机会都减少了。
结论
由于COVID-19对策的影响，虚弱和衰弱前期的患病率可能有所增加。此外，受COVID-19对策影响的社区居住老年人的生活方式发生了变化。生活方式变化在虚弱的老年人中更为明显。
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