内在能力的转变与虚弱状态的关联，以及 3 年残疾。
Associations between transitions of intrinsic capacity and frailty status, and 3-year disability.
机构信息
National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041, Sichuan, China.
Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041, Sichuan, China.
出版信息
BMC Geriatr. 2023 Feb 14;23(1):96. doi: 10.1186/s12877-023-03795-4.
BACKGROUND
The trajectory of frailty and intrinsic capacity (IC) often overlap in older adults. Longitudinal analyses of transitions of frailty and IC, and their associations with incident functional decline are limited. The present study aimed to identify transitions of frailty status and IC, and explore associations between transitions of frailty and IC, and future disability among community-dwelling older adults.
METHODS
In the West China and Aging Trend Study, 808 participants aged ≥ 60 years completed baseline and three years follow-up (frailty, IC and disability assessments). Physical frailty was measured based on Fried phenotype. IC was evaluated by five domains (cognition, locomotion, sensory, psychological, and vitality). Disability was defined as a need for assistance in any items in activity of daily living (ADL) or the instrumental activity of daily living (IADL). Logistic regressions were performed to examine their relationships.
RESULTS
Four transitions of IC status (kept well: 27.4%, improved: 8.4%, worsened: 35.4%, and kept poor: 28.8%), and two transitions of frailty status (kept not-frail/improved: 93.2%, kept frail/worsened: 6.8%) were identified. Impaired locomotion and vitality at baseline were significantly associated with kept frail or worsened frail. However, impaired sensory and vitality at baseline not frailty status was significantly associated with transitions of IC. Adjusted for covariates and transitions of frailty, kept poor IC was associated with ADL (OR = 2.26, 95%CI = 1.17,4.34) and IADL disability (OR = 3.74, 95%CI = 1.79, 7.82).
CONCLUSIONS
Transitions of IC, but not frailty were associated with higher risk of incident disability. Baseline locomotion and vitality impairment were associated with worsened or kept frail. Our findings support the WHO's notion of monitoring and optimizing IC to delay deterioration of IC and preventing frailty and disability.
CLINICAL TRIAL NUMBER
ChiCTR1800018895.
背景
衰弱和内在能力（IC）的轨迹在老年人中经常重叠。衰弱和 IC 转变的纵向分析及其与新发功能下降的关系有限。本研究旨在确定衰弱状态和 IC 的转变，并探讨衰弱和 IC 转变与社区居住的老年人未来残疾之间的关系。
方法
在华西和老龄化趋势研究中，808 名年龄≥60 岁的参与者完成了基线和三年随访（衰弱、IC 和残疾评估）。身体衰弱基于 Fried 表型进行测量。IC 通过五个领域（认知、运动、感觉、心理和活力）进行评估。残疾定义为在日常生活活动（ADL）或工具性日常生活活动（IADL）的任何项目中需要帮助。Logistic 回归用于检查它们之间的关系。
结果
确定了 IC 状态的四种转变（保持良好：27.4%，改善：8.4%，恶化：35.4%，保持较差：28.8%）和衰弱状态的两种转变（保持非虚弱/改善：93.2%，保持虚弱/恶化：6.8%）。基线时运动和活力受损与保持虚弱或恶化虚弱显著相关。然而，基线时感觉和活力受损与 IC 的转变显著相关。调整协变量和衰弱的转变后，保持较差的 IC 与 ADL（OR=2.26，95%CI=1.17，4.34）和 IADL 残疾（OR=3.74，95%CI=1.79，7.82）相关。
结论
IC 的转变，而不是衰弱，与更高的新发残疾风险相关。基线运动和活力受损与恶化或保持虚弱相关。我们的研究结果支持世界卫生组织监测和优化 IC 的概念，以延缓 IC 的恶化，预防虚弱和残疾。
临床试验注册号
ChiCTR1800018895。
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