Li Chia-Lin, Stanaway Fiona F, Chang Hsing-Yi, Chen Min-Chi, Tsai Yu-Hsuan
Department of Health Care Management, College of Management, Chang Gung University, 259 Wen-Hwa 1St Road, Kwei-Shan, Tao-Yuan, 33302, Taiwan.
Faculty of Medicine and Health, School of Public Health, University of Sydney, Sydney, NSW, Australia.
Eur J Ageing. 2023 May 18;20(1):17. doi: 10.1007/s10433-023-00765-y.
The aim of the present study was to investigate how frailty/pre-frailty in combination with subjective memory complaints predicts all-cause mortality in community dwelling cognitively unimpaired older adults. There were 1904 community-dwelling cognitively unimpaired persons aged 65 years or older who participated in the 2013 Taiwan National Health Interview Survey with a 5-year follow-up. Frailty was determined based on the fatigue, resistance, ambulation, illness, and loss of weight (FRAIL) scale. Two questions ("Do you have difficulties with your memory or attention?" and "Do you have difficulties with your memory only or attention only or both?") were used to screen for subjective memory complaints (SMC). In this study, 11.9% of participants had both frailty/pre-frailty and SMC. A total of 239 deaths were recorded after 9009.5 person-years of follow-up. After adjustment for other factors, compared with participants who were physically robust with no SMC, participants who reported either SMC alone (HR = 0.88, 95% CI = 0.60-1.27) or were frail/pre-frail alone (HR = 1.32, 95% CI = 0.90-1.92) had no significantly increased mortality risk. However, coexisting frailty/pre-frailty and SMC was associated with a significantly increased hazard ratio for mortality of 1.48 (95% CI = [1.02-2.16]). Our results highlight the high prevalence of co-occurring frailty/pre-frailty and SMC and that this co-occurrence is associated with an increased risk of mortality among cognitively unimpaired older adults.
本研究的目的是调查虚弱/脆弱前期与主观记忆障碍相结合如何预测社区中认知功能未受损的老年人的全因死亡率。有1904名年龄在65岁及以上、居住在社区且认知功能未受损的人参与了2013年台湾国民健康访谈调查，并进行了为期5年的随访。根据疲劳、抵抗力、步行能力、疾病和体重减轻（FRAIL）量表确定虚弱状态。通过两个问题（“您在记忆或注意力方面有困难吗？”以及“您只是在记忆方面有困难，还是仅在注意力方面有困难，或者两者都有困难？”）来筛查主观记忆障碍（SMC）。在本研究中，11.9%的参与者同时存在虚弱/脆弱前期和SMC。在9009.5人年的随访后，共记录了239例死亡病例。在对其他因素进行调整后，与身体强健且无SMC的参与者相比，仅报告SMC的参与者（风险比[HR]=0.88，95%置信区间[CI]=0.60-1.27）或仅虚弱/脆弱前期的参与者（HR=1.32，95%CI=0.90-1.92）的死亡风险没有显著增加。然而，同时存在虚弱/脆弱前期和SMC与死亡率的风险比显著增加1.48（95%CI=[1.02-2.16]）相关。我们的结果突出了虚弱/脆弱前期和SMC同时出现的高患病率，并且这种同时出现与认知功能未受损的老年人死亡率增加的风险相关。
