中国社区居住的老年人虚弱与长期护理需求的关系：一项横断面研究。

Relationship between frailty and long-term care needs in Chinese community-dwelling older adults: a cross-sectional study.

机构信息

Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.

Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China.

出版信息

BMJ Open. 2022 Apr 29;12(4):e051801. doi: 10.1136/bmjopen-2021-051801.

DOI:10.1136/bmjopen-2021-051801

PMID:35487750

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9058676/

Abstract

OBJECTIVES

Our study aimed to investigate the relationship between the severity of frailty and the long-term care (LTC) needs of older adults from Chinese communities.

DESIGN

A cross-sectional study.

SETTING

Three Chinese community health centres. All data were collected by trained researchers through face-to-face collection.

PARTICIPANTS

We surveyed a total of 540 older residents who aged 60 or older from community in Guangzhou, China.

MEASURES

The Chinese version of the Tilburg frailty indicator was used to assess the frailty status of participants. LTC needs was evaluated by Integrated Home Care Services Questionnaire. Using non-adjusted and multivariate adjusted logistic regression analysis to evaluate frailty and LTC needs, then smoothed plots, threshold effect analysis and P for trend were used to further investigate the relationship between them.

RESULTS

The prevalence of frailty was 45.2% among the 540 older adults enrolled (aged 70.4±8.3 years; 65.7% females). 27% had higher LTC needs, which increased to 65.1% for individuals with frailty. Logistic regression analysis showed that frailty was strongly associated with LTC needs (OR 3.06, 95% CI 2.06 to 4.55, p<0.01). In the multivariate model, after adjusting for demographic characteristics, economic situation, activities of daily living and comorbidities, frailty remained significantly associated with LTC needs (OR 2.32, 95% CI 1.39 to 3.88, p<0.01). The smoothed plots showed a nearly linear relationship between frailty and LTC needs. Threshold effect analysis showed that every point increase in frailty, the score of LTC needs increased 1.3 points. The IQR to regroup individuals with frailty. Compared with the first quartile (scores ≤2), the incidence of LTC needs increased with the frailty status (p value for trend <0.01).

CONCLUSION

There is a linear relationship between frailty and LTC needs. With the increasing degree of frailty, the LTC needs of older adults dramatically increases.

摘要

目的

本研究旨在探讨中国社区老年人虚弱程度与长期护理（LTC）需求之间的关系。

设计

横断面研究。

地点

三个中国社区卫生中心。所有数据均由经过培训的研究人员通过面对面收集。

参与者

我们共调查了来自中国广州社区的 540 名 60 岁及以上的老年人。

措施

采用中文版蒂尔堡虚弱指数评估参与者的虚弱状况。使用综合家庭护理服务问卷评估 LTC 需求。采用非调整和多变量调整逻辑回归分析评估虚弱和 LTC 需求，然后使用平滑图、阈值效应分析和 P 趋势进一步探讨它们之间的关系。

结果

540 名入组老年人中，虚弱的患病率为 45.2%（年龄 70.4±8.3 岁；65.7%为女性）。27%的人有较高的 LTC 需求，而虚弱的人这一比例增加到 65.1%。逻辑回归分析显示，虚弱与 LTC 需求密切相关（OR 3.06，95%CI 2.06 至 4.55，p<0.01）。在多变量模型中，调整人口统计学特征、经济状况、日常生活活动和合并症后，虚弱与 LTC 需求仍显著相关（OR 2.32，95%CI 1.39 至 3.88，p<0.01）。平滑图显示虚弱与 LTC 需求之间几乎呈线性关系。阈值效应分析显示，虚弱程度每增加一点，LTC 需求评分增加 1.3 分。将 IQR 重新分组为虚弱个体。与第一四分位（得分≤2）相比，随着虚弱状况的增加，LTC 需求的发生率增加（趋势 p 值<0.01）。