虚弱的感觉和运动相关性：虚弱表型和虚弱指数的分离。
Sensory and motor correlates of frailty: dissociation between frailty phenotype and frailty index.
机构信息
Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159, Mannheim, Germany.
Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany.
出版信息
BMC Geriatr. 2022 Sep 15;22(1):755. doi: 10.1186/s12877-022-03416-6.
BACKGROUND
Frailty has been associated with a decline in sensory and motor function. However, given that different frailty measures were shown to overlap but also differ in their diagnostic properties, sensory and motor correlates of frailty might be different depending on the operationalization of frailty. Our objective was to identify sensory and motor determinants of frailty and compare the results between frailty phenotype (FP) and frailty index (FI).
METHODS
Data from 44 pre-frail and frail subjects aged 65 and above were used. Frailty was measured using the FP and the FI. Sensory function in the visual, auditory, and tactile domain was assessed using visual acuity, absolute hearing threshold and mechanical detection threshold. Upper extremity motor performance was evaluated by the Purdue Pegboard Test and the Short Physical Performance Battery was used to assess lower extremity motor function. Multiple logistic regression models were employed to determine associations of sensory and motor function with frailty vs. pre-frailty for both frailty measures.
RESULTS
The frailty measures were moderately correlated (0.497, p ≤ 0.01) and had a Kappa agreement of 0.467 (p = 0.002). Using the FP, frailty was significantly associated with reduced upper extremity motor function only (OR = 0.50, 95% CI 0.29-0.87, p = 0.014). Frailty as assessed by the FI was significantly related to higher hearing thresholds (OR = 1.21, 95% CI 1.02-1.43, p = 0.027) and reduced lower extremity performance (OR = 0.32, 95% CI 0.13-0.77, p = 0.012).
CONCLUSION
Frailty is related to reduced performance in measures of sensory and motor function. However, traditional measures of frailty might be differentially sensitive to capture sensory and motor decline, possibly contributing to the much-observed discordance between the diagnostic instruments. This should be taken into account by researchers and clinicians when planning and evaluating therapeutic interventions for frailty.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03666039 . Registered 11 September 2018 - Retrospectively registered.
背景
虚弱与感觉和运动功能下降有关。然而，由于不同的虚弱测量方法在其诊断特性上既有重叠又有不同，因此根据虚弱的操作化，虚弱与感觉和运动的相关性可能会有所不同。我们的目的是确定虚弱的感觉和运动决定因素，并比较表型（FP）和虚弱指数（FI）之间的结果。
方法
使用了 44 名年龄在 65 岁及以上的虚弱和脆弱的老年人的数据。使用 FP 和 FI 来衡量虚弱。使用视力、绝对听力阈值和机械检测阈值评估视觉、听觉和触觉领域的感觉功能。使用 Purdue 钉板测试评估上肢运动表现，使用短体物理性能测试来评估下肢运动功能。采用多元逻辑回归模型确定 FP 和 FI 与虚弱和脆弱的感觉和运动功能之间的关联。
结果
两种虚弱测量方法中度相关（0.497，p≤0.01），kappa 一致性为 0.467（p=0.002）。使用 FP，虚弱与上肢运动功能下降显著相关（OR=0.50，95%CI 0.29-0.87，p=0.014）。使用 FI 评估的虚弱与更高的听力阈值显著相关（OR=1.21，95%CI 1.02-1.43，p=0.027）和下肢运动功能下降显著相关（OR=0.32，95%CI 0.13-0.77，p=0.012）。
结论
虚弱与感觉和运动功能测量中的表现下降有关。然而，传统的虚弱测量方法可能对捕捉感觉和运动的下降具有不同的敏感性，这可能导致诊断仪器之间存在很大的差异。研究人员和临床医生在为虚弱制定治疗干预计划和评估治疗效果时应考虑到这一点。
试验注册
ClinicalTrials.gov NCT03666039. 2018 年 9 月 11 日注册-回顾性注册。
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