Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France; UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France.
Maturitas. 2021 Aug;150:1-6. doi: 10.1016/j.maturitas.2021.05.011. Epub 2021 Jun 4.
AIM: This longitudinal secondary analysis of the Multidomain Alzheimer Preventive Trial (MAPT) aimed to test whether the Integrated Care for Older People (ICOPE) Step 1 screening tool is able to identify people at risk of developing frailty and disability in basic (ADL) and instrumental (IADL) activities of daily living among community-dwelling older adults. PARTICIPANTS AND SETTING: Seven hundred and fifty-nine (n = 759) non-demented participants of the MAPT aged 70-89 years were assessed in memory clinics in France between 2008 and 2013. METHODS: We measured six intrinsic capacity (IC) impairments, adapted from the ICOPE screening tool. We used Cox models to estimate the adjusted hazard ratios of incident frailty and IADL/ADL disability. Incident frailty was defined by Fried's phenotype, and incident disability was measured according to Lawton and Katz for IADLs and ADLs. RESULTS: Limited mobility (HR= 2.97, 95%CI= 1.85-4.76), depressive symptoms (HR= 2.07, 95%CI= 1.03-4.19), and visual impairment (HR= 1.70, 95%CI 1.01-2.86) were associated with a higher incidence of frailty over 5 years. Each additional IC condition demonstrated a positive association with a higher risk of incident frailty, IADL, ADL disability, with risk increased by 47%, 27%, and 23% over 5 years, respectively. CONCLUSION: Screening for IC impairments identifies older adults at higher risk of incident frailty and incident IADL/ADL disability. It is relevant to screen for these impairments together because the risk of frailty and disability increases with each additional one. ClinicalTrials.gov identifier: NCT00672685.
目的:本项针对多领域阿尔茨海默病预防试验(MAPT)的纵向二次分析旨在检验综合老年人护理(ICOPE)第 1 步筛查工具是否能够识别出社区居住的老年人在基本日常生活活动(ADL)和工具性日常生活活动(IADL)中出现体弱和残疾的风险。
参与者和设置:759 名(n=759)无痴呆的 MAPT 参与者于 2008 年至 2013 年在法国的记忆诊所接受评估,年龄在 70-89 岁之间。
方法:我们测量了六个内在能力(IC)损伤,这些损伤改编自 ICOPE 筛查工具。我们使用 Cox 模型估计发生体弱和 IADL/ADL 残疾的调整后的危险比。体弱的发生通过 Fried 表型定义,残疾的发生根据 Lawton 和 Katz 标准测量 IADL 和 ADL。
结果:活动能力受限(HR=2.97,95%CI=1.85-4.76)、抑郁症状(HR=2.07,95%CI=1.03-4.19)和视力障碍(HR=1.70,95%CI 1.01-2.86)与 5 年内发生体弱的风险增加相关。每增加一个 IC 条件与发生体弱、IADL、ADL 残疾的风险呈正相关,风险分别增加 47%、27%和 23%,持续 5 年。
结论:对 IC 损伤进行筛查可识别出体弱和 IADL/ADL 残疾风险较高的老年人。一起筛查这些损伤是相关的,因为每增加一个损伤,体弱和残疾的风险都会增加。临床试验标识符:NCT00672685。
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