CARE 衰弱电子健康量表：与不良健康事件的关联及与 NuAge 队列中心血管健康研究衰弱量表的比较。

CARE frailty e-health scale: Association with incident adverse health outcomes and comparison with the Cardiovascular Health Study frailty scale in the NuAge cohort.

机构信息

Departments of Medicine, University of Montreal, Montreal, Quebec, Canada; Research Centre of the Geriatric University Institute of Montreal, Montreal, Quebec, Canada; Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.

Research Centre of the Geriatric University Institute of Montreal, Montreal, Quebec, Canada.

出版信息

Maturitas. 2022 Aug;162:37-43. doi: 10.1016/j.maturitas.2022.04.006. Epub 2022 Apr 27.

DOI:10.1016/j.maturitas.2022.04.006

PMID:35537241

Abstract

BACKGROUND

This study examines and compares CARE and Cardiovascular Health Study (CHS) frailty states (i.e., robust, prefrail and frail) for their association with incident adverse health outcomes, including falls, depression, cognitive and functional decline, major neurocognitive disorders, hospitalization and mortality in community-dwelling older adults living in the province of Quebec (Canada).

METHODS

A subset of individuals (n = 1098) who participated in "Nutrition as a determinant of successful aging: The Quebec longitudinal study" (NuAge), which is an elderly population-based observational cohort study with 3 years of follow-up, were selected. CARE and CHS frailty states were determined using the NuAge baseline assessment. Incident falls (i.e., ≥1, ≥2 and severe falls), depression (i.e., 30-item Geriatric Depression Scale score > 10/30), decline in cognition (i.e., Modified Mini Mental State (3MS) score < 79/100) and functionality (i.e., Activity Daily Living (ADL) score ≤ 3/4 and an Instrumental Activity Daily Living (IADL) score ≤ 6/8), major neurocognitive disorders (i.e., 3MS score < 79/100 and IADL score < 6/8), hospitalization and mortality were annually recorded over a 3-year follow-up period.

RESULTS

66.8% and 23.6% of participants were classified as pre-frail and frail with CARE respectively, whereas this distribution of frailty states differed with CHS (47.9% and 8.4%). There were significant associations of CARE pre-frail and frail states with all incident adverse health outcomes, the lowest odds ratio (OR) being reported with falls and the highest with cognitive decline (OR ranging from 1.63 to 12.85 with P ≤ 0.032). All ORs of the CARE frailty states were greater than those of the CHS, except for frail participants with IADL decline (OR = 4.92 for CARE versus OR = 9.62 for CHS).

CONCLUSIONS

CARE frail states were associated with incident adverse health outcomes and these associations were greater than with CHS, suggesting that the CARE scale is of clinical interest when screening for frailty and related adverse health outcomes in the elderly population.

摘要

背景

本研究旨在比较加拿大魁北克省社区居住的老年人中，使用 CARE 和心血管健康研究（CHS）的衰弱状态（即强健、衰弱前期和衰弱）来预测不良健康结局（包括跌倒、抑郁、认知和功能下降、主要神经认知障碍、住院和死亡）的关联。

方法

选择了参加“营养作为成功老龄化的决定因素：魁北克纵向研究”（NuAge）的一部分个体（n=1098），这是一项基于老年人群的观察性队列研究，随访时间为 3 年。使用 NuAge 基线评估来确定 CARE 和 CHS 的衰弱状态。记录了 3 年内的不良健康结局的发生情况，包括跌倒（即≥1 次、≥2 次和严重跌倒）、抑郁（即 30 项老年抑郁量表评分>10/30）、认知下降（即改良的简易精神状态检查（3MS）评分<79/100）和功能下降（即日常生活活动（ADL）评分≤3/4 和工具性日常生活活动（IADL）评分≤6/8）、主要神经认知障碍（即 3MS 评分<79/100 和 IADL 评分<6/8）、住院和死亡。

结果

根据 CARE 分类，66.8%和 23.6%的参与者分别为衰弱前期和衰弱，而 CHS 的这种衰弱状态分布不同（47.9%和 8.4%）。CARE 衰弱前期和衰弱状态与所有不良健康结局均有显著关联，最低的优势比（OR）见于跌倒，最高的见于认知下降（OR 范围为 1.63 至 12.85，P≤0.032）。CARE 衰弱状态的所有 OR 均大于 CHS，除了 IADL 下降的衰弱参与者（CARE 的 OR=4.92，CHS 的 OR=9.62）。