老年综合征在类风湿关节炎患者中的表现：老年与年轻患者的比较。
Geriatric Syndromes among Patients with Rheumatoid Arthritis: A Comparison between Young and Elderly Patients.
机构信息
Orthopedic Research Center, Faculty of Medicine, Department of Internal Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
出版信息
Ethiop J Health Sci. 2022 Jul;32(4):791-798. doi: 10.4314/ejhs.v32i4.16.
BACKGROUND
In the general geriatric population, Geriatric syndromes (GSs) predict greater likelihood of hospitalization, increased health care use and cost. The present study aimed to compare GSs among young and elderly patients with rheumatoid arthritis (RA).
METHODS
In a cross-sectional study a total of 98 participants, including 65 elderly (≥60 years) and 33 young adult patients (<60 years) with RA who referred to the geriatric and rheumatologic clinic were enrolled. Patients were categorized into three groups (healthy elderly, n=27; elderly with RA, n=38; and young people with RA, n=33). GSs were assessed using mini-mental state exam (MMSE), five-item geriatric depression scale-15 (GDS-15), mini nutritional assessment (MNA), and asking patients about history of falls in the past year. The RA activity in patients was assessed using disease activity for rheumatoid arthritis score-28 (DAS-28) scale, serum ESR (mm/h) level.
RESULTS
There was a statistically significant differences in terms of DAS-28 (2.23±1.01 vs. 0.64±0.97, P=0.025) and ESR (28.10±6.64 vs. 23.09±7.65 mm/h, P=0.042) between healthy elderly and RA elderly patients. Elderly patients with RA were significantly more prone to have cognitive impairment (P=0.002), fall (P=0.005), malnutrition (P<0.001), urinary incontinence (P<0.001), and functional disability (P=0.021) compared to healthy elderlies and young RA patients. The results of binary logistic regression revealed that in elderly RA patients, higher DAS-28 score [odds ratio (OR) = 1.96; 95% CI 1.03, 3.84; P=0.041] was an independent risk factors for the GSs.
CONCLUSION
The prevalence of some features of GSs were higher in the elderly RA patients than healthy elderly and young RA patients.
背景
在一般老年人群中，老年综合征（GSs）可预测更高的住院可能性、更多的医疗保健使用和更高的成本。本研究旨在比较年轻和老年类风湿关节炎（RA）患者之间的 GSs。
方法
在一项横断面研究中，共纳入 98 名参与者，包括 65 名老年（≥60 岁）和 33 名年轻成年（<60 岁）RA 患者，他们被转诊到老年和风湿科诊所。患者被分为三组（健康老年人，n=27；老年 RA 患者，n=38；年轻 RA 患者，n=33）。使用简易精神状态检查（MMSE）、五分量表老年抑郁量表-15（GDS-15）、微型营养评估（MNA）和询问患者过去一年是否有跌倒史来评估 GSs。使用类风湿关节炎疾病活动评分-28（DAS-28）量表和血清 ESR（mm/h）水平评估患者的 RA 活动。
结果
健康老年人和 RA 老年患者之间 DAS-28（2.23±1.01 与 0.64±0.97，P=0.025）和 ESR（28.10±6.64 与 23.09±7.65 mm/h，P=0.042）存在统计学显著差异。RA 老年患者明显更容易出现认知障碍（P=0.002）、跌倒（P=0.005）、营养不良（P<0.001）、尿失禁（P<0.001）和功能障碍（P=0.021），与健康老年人和年轻 RA 患者相比。二元逻辑回归的结果表明，在老年 RA 患者中，较高的 DAS-28 评分[比值比（OR）=1.96；95%置信区间（CI）1.03，3.84；P=0.041]是 GSs 的独立危险因素。
结论
与健康老年人和年轻 RA 患者相比，老年 RA 患者 GSs 的某些特征更为常见。
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