Department of Geriatrics, Healthy Aging Research Centre (HARC), Medical University of Lodz, Haller Sqr. No. 1, 90-647 Lodz, Poland.
Nutrients. 2023 Aug 25;15(17):3716. doi: 10.3390/nu15173716.
With an increasingly aging population worldwide, the concept of multimorbidity has attracted growing interest over recent years, especially in terms of frailty, which leads to progressive multisystem decline and increased adverse clinical outcomes. The relative contribution of multiple disorders to overall frailty index in older populations has not been established so far. This study aimed to assess the association between the vulnerable elders survey-13 (VES-13) score, which is acknowledged to be one of the most widely used measures of frailty, and the most common accompanying diseases amongst hospitalized adults aged 60 years old and more. A total of 2860 participants with an average age of 83 years were included in this study. Multiple logistic regression with adjustment for age and nutritional status was used to assess the independent impact of every particular disease on vulnerability. Diabetes mellitus type 2, coronary artery disease, atrial fibrillation, heart failure, chronic kidney disease, osteoarthritis, fractures, eyes disorders, depression, dementia, pressure ulcers, and urinary incontinence were associated with higher scores of VES-13. Hospital admission of older subjects with those conditions should primarily draw attention to the risk of functional decline, especially while qualifying older patients for further treatment in surgery and oncology. At the same time, lipid disorders, gastrointestinal diseases, higher body mass index, and albumins level were related to a lower risk of being vulnerable, which may be attributed to a younger age and better nutritional status of those patients.
随着全球人口老龄化的加剧，近年来多病症的概念引起了越来越多的关注，尤其是在脆弱性方面，它导致多系统逐渐衰退和不良临床结局增加。到目前为止，还没有确定多种疾病对老年人群整体脆弱指数的相对贡献。本研究旨在评估脆弱性老年人调查-13（VES-13）评分与 60 岁及以上住院成年人最常见伴随疾病之间的关系，该评分被认为是最广泛使用的脆弱性衡量标准之一。共有 2860 名平均年龄为 83 岁的参与者纳入本研究。使用调整年龄和营养状况的多变量逻辑回归来评估每种特定疾病对脆弱性的独立影响。2 型糖尿病、冠状动脉疾病、心房颤动、心力衰竭、慢性肾脏病、骨关节炎、骨折、眼部疾病、抑郁、痴呆、压疮和尿失禁与 VES-13 较高评分相关。患有这些疾病的老年患者住院应主要引起对功能下降风险的关注，特别是在对老年患者进行手术和肿瘤学治疗资格认定时。与此同时，血脂紊乱、胃肠道疾病、较高的体重指数和白蛋白水平与较低的脆弱风险相关，这可能归因于这些患者更年轻和更好的营养状况。
