Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
Southern Cross Care (SA, NT & Vic) Inc., PO Box 155, Glen Osmond, SA, 5064, Australia.
BMC Geriatr. 2022 May 14;22(1):424. doi: 10.1186/s12877-022-03101-8.
Physical frailty is associated with increased risk of falls, hospitalisation and mortality. There is a dearth of information on physical frailty of older adults living in residential aged care. This study aimed to describe physical frailty in aged care residents and investigate possible determinants of frailty.
A retrospective audit of resident records was undertaken across 14 residential aged care facilities. Data were extracted on all consenting residents who had completed measures relating to frailty (Short Physical Performance Battery SPPB; grip strength). All data of the first record of measures were extracted, resident characteristics, and the time from admission to assessment. Summary statistics were completed. Differences between sub-groups were explored (Mann-Whitney U, Kruskall-Wallis Ranked tests). Associations between variables were explored with Chi-squared and Pearson correlations. Determinants of physical frailty were determined with linear regression analyses. Alpha (2-sided) was 0.05.
Data were extracted for 1241 residents (67% female), with a mean age of 86.0 (7.6) years. Males had a significantly lower time from admission to assessment of frailty (p ≤ 0.001). The average SPPB score was 4.1 (3.3), 75% of residents were frail and 19% pre-frail. Bivariate analyses indicated no significant relationships between grip strength and SPPB score, but significant differences for grip strength, where males were significantly stronger (males 20.2 ± 8.3 kg; females 12.4 ± 5.4 kg; p ≤ 0.001). There was a significant positive relationship between SPPB total score and grip strength, gender (p ≤ 0.001), and marital status (p = 0.049) and a negative relationship between time from admission to assessment and SPPB total score (p ≤ 0.001). There were significant negative relationships between gender (p ≤ 0.001) and age (p ≤ 0.001), and time from admission to assessment (p ≤ 0.001) with grip strength.
Older adults living in residential aged care have a high level of physical frailty which may lead to increased risk of adverse outcomes. Time in the residential aged care setting and age appear to predict physical frailty. There is a need for a consistent battery of measures to continually monitor frailty and programs to address the high levels of frailty in residential aged care.
身体虚弱与跌倒、住院和死亡风险增加有关。关于居住在养老院的老年人身体虚弱的信息很少。本研究旨在描述养老院居民的身体虚弱，并调查虚弱的可能决定因素。
对 14 家养老院的居民记录进行回顾性审计。对所有同意完成与虚弱相关措施（简短体能表现电池 SPPB；握力）的居民提取数据。提取所有第一次测量记录的数据、居民特征以及从入院到评估的时间。完成汇总统计。探索亚组之间的差异（Mann-Whitney U、Kruskal-Wallis 等级检验）。使用卡方和皮尔逊相关系数探索变量之间的关联。使用线性回归分析确定身体虚弱的决定因素。双侧 alpha（2 侧）为 0.05。
共提取了 1241 名居民的数据（67%为女性），平均年龄为 86.0（7.6）岁。男性从入院到评估虚弱的时间明显更短（p≤0.001）。SPPB 平均得分为 4.1（3.3），75%的居民虚弱，19%的居民为虚弱前期。双变量分析表明，握力与 SPPB 评分之间没有显著关系，但握力存在显著差异，男性握力明显更强（男性 20.2±8.3kg；女性 12.4±5.4kg；p≤0.001）。SPPB 总分与握力、性别（p≤0.001）和婚姻状况（p=0.049）呈显著正相关，与从入院到评估的时间呈显著负相关（p≤0.001）。性别（p≤0.001）和年龄（p≤0.001）与入院到评估的时间与握力呈显著负相关。
居住在养老院的老年人身体虚弱程度较高，可能导致不良后果风险增加。在养老院的时间和年龄似乎预测身体虚弱。需要一套一致的测量工具来持续监测虚弱，并制定计划来解决养老院中高水平的虚弱。
