Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
BMJ Open. 2021 Aug 6;11(8):e049795. doi: 10.1136/bmjopen-2021-049795.
Self-rated health (SRH) is an assessment and predictor of health based on an individual's general condition; however, evidence of the value of SRH for predicting frailty remains scarce for older Asian adults. This study aimed to evaluate the relationship between SRH score trajectory and frailty among older individuals in Taiwan.
An 8-year retrospective cohort study.
Data were retrieved from the Taiwan Longitudinal Study on Aging from 1999 to 2007.
Respondents aged 53-69 years old who were not frail or disabled in 1999 (n=1956).
Frailty was defined using the Fried criteria. The group-based trajectory modelling technique was used to estimate SRH trajectories. Logistic regression analysis was used to examine the associations between changes in SRH and frailty.
Four SRH trajectory classes were identified across the 8-year follow-up: 232 participants (11.9%) were classified into the constantly poor SRH group, 1123 (57.4%) into the constantly fair SRH group, 335 (17.1%) into the constantly good SRH group and 266 (13.6%) into the good-to-fair SRH group. After adjusting for gender, age, level of education, income, social participation, health behaviours and major comorbidities, it was found that age, poor income satisfaction, without job and constantly poor SRH were associated with increased risk of frailty, while constantly good SRH (OR 0.04, 95% CI (0.01 to 0.32)) and good-to-fair SRH (OR 0.19, 95% CI (0.06 to 0.63)) were associated with reduced risks of frailty.
Constantly poor SRH was associated with an increased risk of frailty in older age. SRH in older adults should be recognised as a predictive tool for future frailty. Diet and exercise interventions may help to prevent frailty among high-risk older individuals with constantly low SRH.
自评健康（SRH）是一种基于个体总体状况的健康评估和预测方法；然而，对于亚洲老年人来说，SRH 预测衰弱的价值证据仍然很少。本研究旨在评估台湾老年人的 SRH 评分轨迹与衰弱之间的关系。
一项 8 年回顾性队列研究。
数据来自 1999 年至 2007 年的台湾老龄化纵向研究。
1999 年无衰弱或残疾且年龄在 53-69 岁的受访者（n=1956）。
衰弱采用 Fried 标准定义。使用基于群组的轨迹建模技术估计 SRH 轨迹。使用逻辑回归分析检查 SRH 变化与衰弱之间的关联。
在 8 年的随访中，确定了 4 种 SRH 轨迹类别：232 名参与者（11.9%）被归类为持续较差的 SRH 组，1123 名（57.4%）为持续一般的 SRH 组，335 名（17.1%）为持续较好的 SRH 组，266 名（13.6%）为较好到一般的 SRH 组。在校正性别、年龄、教育水平、收入、社会参与、健康行为和主要合并症后，发现年龄、较差的收入满意度、无工作和持续较差的 SRH 与衰弱风险增加相关，而持续较好的 SRH（OR 0.04，95%CI（0.01 至 0.32））和较好到一般的 SRH（OR 0.19，95%CI（0.06 至 0.63））与衰弱风险降低相关。
持续较差的 SRH 与老年人衰弱风险增加相关。老年人的 SRH 应被视为预测未来衰弱的工具。饮食和运动干预可能有助于预防高风险、持续低 SRH 的老年人衰弱。
