Department of Urology, University of California, San Francisco, San Francisco, California.
Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.
Urol Pract. 2022 Jul;9(4):314-320. doi: 10.1097/UPJ.0000000000000309. Epub 2022 May 2.
We sought to understand regional variation of frailty across health service areas (HSAs) in Northern and Central California among older adults with benign urological conditions.
This retrospective study utilizes the University of California, San Francisco Geriatric Urology Database, which includes adults ≥65 years old with benign urological conditions who underwent a Timed Up and Go Test (TUGT) between December 2015 and June 2020. The TUGT is a validated proxy for frailty, whereby a TUGT ≤10 seconds represents robust individuals and a TUGT >10 seconds represents prefrail and frail individuals. Subjects were assigned to the HSA wherein they live, and HSAs were stratified by mean TUGT scores. Analyses were conducted at the HSA level. Characteristics associated with prefrail/frail HSAs were identified using multivariable logistic regression. Least square means were used to determine variation in adjusted mean TUGT scores.
A total of 2,596 subjects were stratified into 69 HSAs in Northern and Central California. Twenty-one HSAs were categorized as robust and 48 HSAs were categorized as prefrail/frail. Prefrail/frail HSAs were significantly associated with older age (adjusted odds ratio [aOR] 4.03, CI 3.29-4.94, p <0.001), female sex (aOR 1.10, CI 1.07-1.11, p <0.001), non-White race (aOR 1.12, CI 1.10-1.14, p <0.001), underweight body mass index (BMI; aOR 1.14, CI 1.07-1.22, p <0.001) and obese BMI (aOR 1.06, CI 1.04-1.08, p <0.001). There was a 1.7-fold difference in mean TUGT values across HSAs.
Older age, non-White race, and underweight and obese BMIs are associated with prefrail/frail HSAs. Further investigation into health disparities as they pertain to geography and frailty is needed to expand upon these findings.
我们旨在了解加利福尼亚州北部和中部老年人良性泌尿科疾病的健康服务区（HSAs）之间的脆弱性区域差异。
这项回顾性研究利用了加利福尼亚大学旧金山老年泌尿科数据库，该数据库包括≥65 岁的成年人，他们在 2015 年 12 月至 2020 年 6 月之间进行了计时起立行走测试（TUGT）。TUGT 是脆弱性的有效替代指标，TUGT≤10 秒表示健壮个体，TUGT>10 秒表示虚弱和虚弱个体。将受试者分配到他们居住的 HSA 中，并根据平均 TUGT 评分对 HSA 进行分层。在 HSA 层面进行分析。使用多变量逻辑回归确定与虚弱/虚弱 HSA 相关的特征。使用最小二乘均值确定调整后 TUGT 评分的变化。
共有 2596 名受试者在加利福尼亚州北部和中部分为 69 个 HSA。21 个 HSA 被归类为健壮，48 个 HSA 被归类为虚弱/虚弱。虚弱/虚弱的 HSA 与年龄较大（调整后的优势比 [aOR] 4.03，CI 3.29-4.94，p <0.001）、女性（aOR 1.10，CI 1.07-1.11，p <0.001）、非白种人（aOR 1.12，CI 1.10-1.14，p <0.001）、体重不足的 BMI（aOR 1.14，CI 1.07-1.22，p <0.001）和肥胖 BMI（aOR 1.06，CI 1.04-1.08，p <0.001）显著相关。HSAs 之间的平均 TUGT 值差异为 1.7 倍。
年龄较大、非白种人和体重不足和肥胖 BMI 与虚弱/虚弱 HSA 相关。需要进一步研究与地理和脆弱性相关的健康差异，以进一步扩大这些发现。
