动物命名测试与肝硬化患者和非肝硬化患者的不良患者报告结局和虚弱相关：一项前瞻性队列研究。
Animal Naming Test Is Associated With Poor Patient-Reported Outcomes and Frailty in People With and Without Cirrhosis: A Prospective Cohort Study.
机构信息
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Center for Clinical Management Research, Veterans Affairs Ann Arbor Health System, Ann Arbor, Michigan, USA.
出版信息
Clin Transl Gastroenterol. 2022 Jan 12;13(1):e00447. doi: 10.14309/ctg.0000000000000447.
INTRODUCTION
Cognitive dysfunction is a major driver of care complexity, poor patient-reported outcomes, and frailty for people with cirrhosis. The performance and clinical associations of the animal naming test (ANT) in the general population are unknown. We evaluated ANT performance in a representative sample of older Americans with and without chronic liver disease (CLD).
METHODS
We analyzed 6,661 subjects enrolled in the 2010-2016 Health and Retirement Survey, a representative cohort of >30,000 US adults. Average age of participants was 75 years. We evaluated 3 subject subgroups: (i) without CLD, (ii) noncirrhosis CLD, and (iii) cirrhosis. We determined the association between the ANT (overall) and S-ANT1 <10 (adjusted for age and education) and health status, basic and instrumental activities of daily living, healthcare utilization (care hours received and hospitalizations), and frailty measures (hand grip and walk speed).
RESULTS
Overall, 8.2% of the sample had noncirrhotic CLD and 1.3% had cirrhosis. CLD or cirrhosis was not independently associated with ANT. Poor ANT performance was associated with poor health status and frailty overall. An S-ANT <10 was associated with fair-poor self-reported health (odds ratio [OR] 1.37; 95% confidence interval [CI]: 1.20-1.56), care hours received (incidence rate ratio [IRR] 2.39; 95% CI: 1.79-3.19), and hospitalizations (IRR 1.14; 95% CI: 1.03-1.26). S-ANT <10 was also associated with activities of daily living disability (OR 1.31; 95% CI: 1.13-1.51), instrumental activities of daily living disability (OR 1.85; 95% CI: 1.59-2.14), weaker hand grip (IRR 0.94; 95% CI: 0.92-0.96), and time to walk 2.5 m (IRR 1.23; 95% CI: 1.17-1.29).
DISCUSSION
ANT performance is not specific to CLD/cirrhosis but is associated with patient-reported outcomes and frailty in a nationally representative sample of elderly subjects with and without CLD.
简介
认知功能障碍是导致肝硬化患者护理复杂性增加、患者报告结局较差和虚弱的主要因素。动物命名测试（ANT）在普通人群中的表现和临床相关性尚不清楚。我们评估了 ANT 在有和没有慢性肝病（CLD）的美国老年人代表性样本中的表现。
方法
我们分析了参加 2010-2016 年健康与退休调查的 6661 名受试者，这是一项超过 30000 名美国成年人的代表性队列。参与者的平均年龄为 75 岁。我们评估了 3 个受试者亚组：（i）无 CLD，（ii）非肝硬化 CLD 和（iii）肝硬化。我们确定了 ANT（整体）和 S-ANT1<10（调整年龄和教育）与健康状况、基本和工具性日常生活活动、医疗保健利用（接受的护理小时数和住院）和脆弱性测量（握力和步行速度）之间的关联。
结果
总体而言，样本中有 8.2%患有非肝硬化 CLD，1.3%患有肝硬化。CLD 或肝硬化与 ANT 无关。整体上，认知功能障碍较差与健康状况不佳和虚弱有关。S-ANT<10 与较差的自我报告健康状况（优势比[OR]1.37；95%置信区间[CI]：1.20-1.56）、接受的护理小时数（发病率比[IRR]2.39；95%CI：1.79-3.19）和住院（IRR 1.14；95%CI：1.03-1.26）有关。S-ANT<10 也与日常生活活动障碍（OR 1.31；95%CI：1.13-1.51）、工具性日常生活活动障碍（OR 1.85；95%CI：1.59-2.14）、握力较弱（IRR 0.94；95%CI：0.92-0.96）和 2.5 米步行时间（IRR 1.23；95%CI：1.17-1.29）有关。
讨论
ANT 的表现并非特异性地针对 CLD/肝硬化，但在有和没有 CLD 的老年受试者的全国代表性样本中，与患者报告的结果和脆弱性有关。
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