Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Gerontology Department, VUB, Brussels, Belgium.
BMC Geriatr. 2023 Aug 11;23(1):485. doi: 10.1186/s12877-023-04178-5.
Knowledge opportunities lie ahead as everyday activities, social participation, and psychological resilience might be important predictors for frailty state transitioning in the oldest old. Therefore, this article aims to examine whether changes in basic-, instrumental-, advanced- activities of daily living (b-, i-, a-ADLs), social participation, and psychological resilience predict both a transition from robustness to prefrailty or frailty and vice versa among community-dwelling octogenarians over a follow-up period of one year.
To evaluate worsened and improved frailty transitions after one year in 322 octogenarians (M = 83.04 ± 2.78), the variables sex, ADLs (b-ADL-DI, i-ADL-DI, a-ADL-DI as baseline and as difference after 6 months values), the CD-RISC (Connor-Davidson Resilience Scale, as baseline and as difference after 6 months), the social participation variables (total participation score, being a member, total number of memberships, level of social participation, being a board member, volunteering, and formal participation as baseline and as difference after 6 months values), were included in a logistic regression analysis.
Limitations in a-ADLs at baseline (OR: 1.048, 95% confidence interval, 1.010-1.090) and an increment of limitations in a-ADLs after 6 months (OR: 1.044, 95% confidence interval, 1.007-1.085) were predictors to shift from robust to a worsened frailty state after one year follow-up. Additionally, being a woman (OR: 3.682, 95% confidence interval, 1.379-10.139) and social participation, specifically becoming a board member in 6 months (OR: 4.343, 95% confidence interval, 1.082-16.347), were protectors of robustness and thus related to an improved frailty transition after one year.
Encouraging healthy lifestyle behaviors to help the maintenance of ADLs, possibly leading to more social participation, could be promising in the prevention of frailty.
日常活动、社会参与和心理弹性可能是预测最年长老年人脆弱状态转变的重要因素，因此，本研究旨在检验基本活动、工具活动、高级活动（b-ADL、i-ADL、a-ADL）、社会参与和心理弹性的变化是否能预测社区居住的 80 岁以上老年人在随访 1 年内从健壮状态向衰弱前期或衰弱状态的转变，以及从衰弱前期或衰弱状态向健壮状态的转变。
为了评估 322 名 80 岁以上老年人在 1 年后衰弱状态的恶化和改善情况（M=83.04±2.78），在逻辑回归分析中纳入了性别、ADL（基线时的 b-ADL-DI、i-ADL-DI、a-ADL-DI 以及 6 个月后差值）、CD-RISC（Connor-Davidson 弹性量表，基线和 6 个月后差值）、社会参与变量（总参与评分、成员身份、总会员人数、社会参与水平、董事会成员、志愿服务和正式参与，基线和 6 个月后差值）。
基线时 a-ADL 受限（OR：1.048，95%置信区间：1.010-1.090）和 6 个月后 a-ADL 受限增加（OR：1.044，95%置信区间：1.007-1.085）是 1 年后从健壮状态向衰弱状态恶化的预测因素。此外，女性（OR：3.682，95%置信区间：1.379-10.139）和社会参与，特别是 6 个月内成为董事会成员（OR：4.343，95%置信区间：1.082-16.347）是健壮状态的保护因素，因此与 1 年后衰弱状态的改善有关。
鼓励健康的生活方式行为以帮助维持日常生活活动能力，可能会促进更多的社会参与，从而有望预防衰弱。
