Nagano Masahiro, Kabayama Mai, Ohata Yuka, Rakugi Hiromi, Kamide Kei
Nagano Clinic.
Department of Health Science, Osaka University Graduate School of Medicine.
Nihon Ronen Igakkai Zasshi. 2022;59(3):360-370. doi: 10.3143/geriatrics.59.360.
The late-stage medical care system for older people provides medical examinations, including questionnaires for frailty. We examined whether or not this approach is useful in clinical practice.
We used this questionnaire for the screening of frailty as follows: according to the manual prepared by the Japan Geriatrics Society, each question was classified as concerning oral (Q4, 5), physical (Q6-9), cognitive (Q10, 11), or social (Q13-15) frailty. Each frailty was defined if there was at least one negative answer in each question. The grip power and skeletal muscle index (SMI) according to a bioelectrical impedance analysis were also evaluated. Subjects who showed a reduced grip strength and SMI were defined as having sarcopenia, and those who showed only a reduced grip strength were defined as having possible sarcopenia.
One hundred and seventy-one subjects aged 81.0±4.2 years old (63.1% female) were enrolled. A total of 12.3% of subjects showed sarcopenia, and 17.5% showed possible sarcopenia. The prevalence of physical, cognitive, and social frailties was associated with sarcopenia. Oral frailty, defined as having decreased swallowing and mastication functions (Q4 and 5), was significantly related to sarcopenia. Physical frailty was associated with age. In patients with hypertension, a low incidence of cognitive frailty was found. Social frailty was related to a decreased body weight.
A questionnaire during medical examinations for older subjects may be useful for screening various frailties and may lead to promotion of the preventive care activities in the community. Further studies are needed to elucidate the relationship between each type of frailty and background characteristics.
老年人晚期医疗护理系统提供医学检查，包括衰弱问卷。我们研究了这种方法在临床实践中是否有用。
我们使用该问卷进行衰弱筛查，具体如下：根据日本老年医学会编写的手册，每个问题被归类为涉及口腔（问题4、5）、身体（问题6 - 9）、认知（问题10、11）或社会（问题13 - 15）衰弱。如果每个问题中至少有一个否定答案，则定义为存在每种衰弱。还评估了根据生物电阻抗分析得出的握力和骨骼肌指数（SMI）。握力和SMI降低的受试者被定义为患有肌肉减少症，仅握力降低的受试者被定义为可能患有肌肉减少症。
纳入了171名年龄为81.0±4.2岁（63.1%为女性）的受试者。共有12.3%的受试者表现出肌肉减少症，17.5%表现出可能的肌肉减少症。身体、认知和社会衰弱的患病率与肌肉减少症相关。定义为吞咽和咀嚼功能下降（问题4和5）的口腔衰弱与肌肉减少症显著相关。身体衰弱与年龄有关。在高血压患者中，认知衰弱的发生率较低。社会衰弱与体重减轻有关。
针对老年受试者的医学检查问卷可能有助于筛查各种衰弱情况，并可能促进社区预防保健活动。需要进一步研究以阐明每种衰弱类型与背景特征之间的关系。
