Mori Takara, Nagai Koutatsu, Tamaki Kayoko, Kusunoki Hiroshi, Wada Yosuke, Tsuji Shotaro, Matsuzawa Ryota, Sano Kyoko, Amano Manabu, Shinmura Ken
Department of General Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; Amagasaki Medical COOP Honden Clinic, Amagasaki, Hyogo, Japan.
School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Hyogo, Japan.
Exp Gerontol. 2022 Oct 15;168:111930. doi: 10.1016/j.exger.2022.111930. Epub 2022 Aug 17.
We aimed to clarify the factors that contribute to the improvement or progression of frailty in rural Japanese community-dwelling older adults.
Of the 840 participants in the cohort study of independent older adults aged 65 years and older living in the Tamba-Sasayama area of Hyogo Prefecture (FESTA study) from September 2016 to December 2017, 551 participated in the 2-year follow-up survey from September 2018 to December 2019.
We evaluated clinical background, physical and cognitive function, total physical activity, daily protein intake, quality of life (QOL) using the WHOQOL-BREF (WHOQOL-26), and frailty status diagnosed using the Japanese version of the Cardiovascular Health Study. We compared the frailty status at the initial and follow-up examinations and classified the participants into three groups: improvement, unchanged, and worsening. Each parameter was compared among the three groups and the factors contributing to the improvement or worsening of frailty status were analyzed using a modified Poisson regression analysis.
The median age at the first survey was 72 years (range: 68-76); 190 men and 361 women were enrolled. The improvement group consisted of individuals with a change in status from frail to prefrail/robust and from prefrail to robust (n = 114); the worsening group consisted of individuals with a change in status from robust to prefrail/frail and from prefrail to frail (n = 92). The physical domain of QOL was significantly associated with an improvement in frailty status independent of the frailty status at baseline. Contrastingly, any domains of QOL were not significantly associated with a worsening frailty status.
This study demonstrated for the first time that QOL has a significant impact on the future improvement and progression of frailty status and that QOL conditions and frailty status affect older adults bidirectionally.
我们旨在阐明日本农村社区居住的老年人衰弱改善或进展的相关因素。
在2016年9月至2017年12月于兵库县丹波筱山市地区开展的65岁及以上独立老年人队列研究（FESTA研究）的840名参与者中，有551人参与了2018年9月至2019年12月的2年随访调查。
我们评估了临床背景、身体和认知功能、总体身体活动、每日蛋白质摄入量、使用世界卫生组织生存质量简表（WHOQOL - 26）评估的生活质量（QOL）以及使用日本版心血管健康研究诊断的衰弱状态。我们比较了初始检查和随访检查时的衰弱状态，并将参与者分为三组：改善组、不变组和恶化组。对三组之间的每个参数进行比较，并使用改良泊松回归分析来分析导致衰弱状态改善或恶化的因素。
首次调查时的中位年龄为72岁（范围：68 - 76岁）；纳入了190名男性和361名女性。改善组包括状态从衰弱转变为衰弱前期/非衰弱以及从衰弱前期转变为非衰弱的个体（n = 114）；恶化组包括状态从非衰弱转变为衰弱前期/衰弱以及从衰弱前期转变为衰弱的个体（n = 92）。生活质量的身体领域与衰弱状态的改善显著相关，且独立于基线时的衰弱状态。相反，生活质量的任何领域与衰弱状态的恶化均无显著关联。
本研究首次表明，生活质量对衰弱状态的未来改善和进展有显著影响，且生活质量状况和衰弱状态对老年人具有双向影响。
