中国中老年人群衰弱与跌倒风险的关联：一项全国代表性队列研究。

Association of Frailty Status with Risk of Fall among Middle-Aged and Older Adults in China: A Nationally Representative Cohort Study.

机构信息

Leilei Duan and Pengpeng Ye National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China, E-mail: duanleilei@ncncd,chinacdc.cn, yepengpeng@ncncd,chinacdc.cn.

出版信息

J Nutr Health Aging. 2021;25(8):985-992. doi: 10.1007/s12603-021-1655-x.

DOI:10.1007/s12603-021-1655-x

PMID:34545918

Abstract

OBJECTIVES

To investigate the association between frailty status and risk of fall among middle-aged and older Chinese people.

DESIGN

A nationally representative prospective cohort study.

SETTING AND PARTICIPANTS

The study included 13,877 community-dwelling participants aged 45 years and above from the China Health and Retirement Longitudinal Study.

METHODS

Frailty status was identified by the frailty index of health deficit accumulation. 34 variables at baseline were selected to calculate the frailty index. We excluded participants with incomplete information in construction of the frailty index at baseline. Falls were measured based on the respondents' self-report. We used a logistic regression model to estimate the associations between the frailty status and risk of fall, and subgroup analyses and sensitivity analyses were further conducted.

RESULTS

Of 13,877 participants, 2310 (16.6%) had falls during the observation period. 9027 (65.0%) participants were classified as robust, 4019 (29.0%) participants were classified as pre-frail, and 831 (6.0%) participants were classified as frail. Our results indicated per 0.01 increment in the frailty index was significantly associated with an increased risk of fall among middle-aged and older participants (OR: 1.52, 95%CI: 1.45-1.60). Such association was stronger when frailty was presented as a categorical variable, with an OR of 1.75 (95%CI: 1.59-1.93) for pre-frail and 3.04 (95%CI: 2.60-3.56) for frail. The area under the curve of the logistic model was 0.612 (95%CI: 0.600-0.625). Each 0.01 increment of the frailty index was association with a higher risk of fall among middle-aged (45-59years) participants (OR: 1.44, 95%CI: 1.29-1.60) than among older (≥60 years) participants (OR: 1.28, 95%CI: 1.16-1.41) at baseline (p=0.015 for interaction).

CONCLUSION

Frailty was significantly associated with an increased risk of fall among community-dwelling middle-aged and older people in China. It is necessary to screen and recognize frailty status to prevent falls among middle-aged and older adults.

摘要

目的

调查中国中老年人群衰弱状况与跌倒风险的关系。

设计

全国代表性的前瞻性队列研究。

地点和参与者

该研究纳入了来自中国健康与退休纵向研究的 13877 名 45 岁及以上的社区居民。

方法

使用健康缺陷累积的衰弱指数来确定衰弱状况。在基线时选择了 34 个变量来计算衰弱指数。我们排除了在基线构建衰弱指数时信息不完整的参与者。根据受访者的自我报告来测量跌倒情况。我们使用逻辑回归模型来估计衰弱状况与跌倒风险之间的关联，并进行了亚组分析和敏感性分析。

结果

在 13877 名参与者中，2310 名（16.6%）在观察期间发生了跌倒。9027 名（65.0%）参与者被归类为健壮，4019 名（29.0%）参与者被归类为虚弱前期，831 名（6.0%）参与者被归类为衰弱。我们的结果表明，衰弱指数每增加 0.01，中老年参与者发生跌倒的风险就会显著增加（OR：1.52，95%CI：1.45-1.60）。当衰弱以分类变量表示时，这种关联更强，虚弱前期的 OR 为 1.75（95%CI：1.59-1.93），衰弱的 OR 为 3.04（95%CI：2.60-3.56）。逻辑模型的曲线下面积为 0.612（95%CI：0.600-0.625）。衰弱指数每增加 0.01，与中年（45-59 岁）参与者发生跌倒的风险增加相关（OR：1.44，95%CI：1.29-1.60），而与老年（≥60 岁）参与者发生跌倒的风险增加相关（OR：1.28，95%CI：1.16-1.41）（p=0.015 用于交互作用）。