Takahashi Paul, Wi Chung-Il, Ryu Euijung, King Katherine, Hickman Joel, Pignolo Robert, Juhn Young
Mayo Clinic Rochester Rochester Minnesota USA.
Mayo Clinic Rochester, Health Science Research Rochester Minnesota USA.
Health Sci Rep. 2022 Aug 14;5(5):e750. doi: 10.1002/hsr2.750. eCollection 2022 Sep.
Influenza is a challenging infectious illness for older adults. It is not completely clear whether influenza is associated with frailty or functional decline. We sought to determine the association between incident influenza infection and frailty and prefrailty in community patients over 50 years of age. We also investigated the association between influenza vaccination and frailty and prefrailty as a secondary aim.
This was a prospective community cohort study from October 2019 to November 2020 in participants over 50 years. The primary outcome was the development of frailty as defined by three of five frailty criteria (slow gait speed, low grip strength, 5% weight loss, low energy, and low physical functioning). The primary predictor was a positive polymerase chain reaction (PCR) for influenza infection. Influenza vaccination was based on electronic health record reviewing 1 year before enrollment. We reported the relationship between influenza and frailty by calculating odds ratios (OR) with 95% confidence intervals (CI) after adjustment for age, sex, socioeconomic status, Charlson Comorbidity Index (CCI), influenza vaccine, and previous self-rated frailty from multinomial logistic regression model comparing frail and prefrail to nonfrail subjects.
In 1135 participants, the median age was 67 years (interquartile range 60-74), with 41% men. Eighty-one participants had PCR-confirmed influenza (7.1%). Frailty was not associated with influenza, with an OR of 0.50 (95% CI 0.17-1.43) for frail participants compared to nonfrail participants. Influenza vaccination is associated with frailty, with an OR of 1.69 (95% CI 1.09-2.63) for frail compared to nonfrail. Frailty was associated with a higher CCI with an OR of 1.52 (95% CI 1.31-1.76).
We did not find a relationship between influenza infection and frailty. We found higher vaccination rates in participants with frailty compared to nonfrail participants While influenza was not associated with frailty, future work may involve longer follow-up.
流感对于老年人来说是一种具有挑战性的传染病。目前尚不完全清楚流感是否与身体虚弱或功能衰退有关。我们试图确定50岁以上社区患者新发流感感染与身体虚弱及虚弱前期之间的关联。作为次要目的，我们还研究了流感疫苗接种与身体虚弱及虚弱前期之间的关联。
这是一项于2019年10月至2020年11月针对50岁以上参与者开展的前瞻性社区队列研究。主要结局是根据五项虚弱标准中的三项（步态速度缓慢、握力低、体重减轻5%、能量低和身体功能低下）定义的身体虚弱的发生情况。主要预测因素是流感感染的聚合酶链反应（PCR）呈阳性。流感疫苗接种情况基于入组前1年的电子健康记录回顾。在对年龄、性别、社会经济地位、查尔森合并症指数（CCI）、流感疫苗以及多项逻辑回归模型中先前的自我评定虚弱情况进行调整后，我们通过计算比值比（OR）及95%置信区间（CI）来报告流感与身体虚弱之间的关系，该模型将虚弱和虚弱前期受试者与非虚弱受试者进行比较。
在1135名参与者中，中位年龄为67岁（四分位间距60 - 74岁），男性占41%。81名参与者的PCR检测确诊为流感（7.1%）。身体虚弱与流感无关，与非虚弱参与者相比，虚弱参与者的OR为0.50（95% CI 0.17 - 1.43）。流感疫苗接种与身体虚弱有关，与非虚弱参与者相比，虚弱参与者的OR为1.69（95% CI 1.09 - 2.63）。身体虚弱与较高的CCI相关，OR为1.52（95% CI 1.31 - 1.76）。
我们未发现流感感染与身体虚弱之间存在关联。我们发现与非虚弱参与者相比，虚弱参与者的疫苗接种率更高。虽然流感与身体虚弱无关，但未来的研究可能需要更长时间的随访。
