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在老年人综合护理背景下,作为脆弱性和残疾风险增加的标志物,对内在能力障碍进行筛查:MAPT 的二次分析。

Screening for intrinsic capacity impairments as markers of increased risk of frailty and disability in the context of integrated care for older people: Secondary analysis of MAPT.

机构信息

Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France; UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France.

出版信息

Maturitas. 2021 Aug;150:1-6. doi: 10.1016/j.maturitas.2021.05.011. Epub 2021 Jun 4.


DOI:10.1016/j.maturitas.2021.05.011
PMID:34274071
Abstract

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.

摘要

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。

相似文献

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Screening for intrinsic capacity impairments as markers of increased risk of frailty and disability in the context of integrated care for older people: Secondary analysis of MAPT.

Maturitas. 2021-8

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[3]
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[6]
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[7]
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[10]
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Combinations of intrinsic capacity and frailty and their associations with self-rated health in community-dwelling older adults.

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[2]
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[3]
Impact of impaired intrinsic capacity on postoperative frailty in elderly patients undergoing colorectal surgery: study protocol for a single-center, prospective, cohort study.

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[4]
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[5]
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[6]
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[7]
Factors influencing the self-management ability among older adults experiencing intrinsic capacity decline: a cross-sectional study.

Front Aging Neurosci. 2024-11-22

[8]
Integrated care for older people improved intrinsic capacity in elderly patients: a case control study.

BMC Geriatr. 2024-10-31

[9]
A latent profile analysis of rest-activity behavior patterns among community-dwelling older adults and its relationship with intrinsic capacity.

Sci Rep. 2024-8-13

[10]
The assessment and detection rate of intrinsic capacity deficits among older adults: a systematic review and meta-analysis.

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