Hu Fang-Wen, Yueh Fang-Ru, Fang Tzu-Jung, Chang Chia-Ming, Lin Chung-Ying
School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan,
Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan,
Gerontology. 2024;70(2):165-172. doi: 10.1159/000535413. Epub 2023 Nov 23.
The relationship among physiologic reserve, intrinsic capacity, and physical resilience has not been examined, and a conceptual model that includes these key determinants of healthy ageing is needed. This study aimed to test a conceptual model using real-world data to determine the relationships among physiologic reserve, intrinsic capacity, physical resilience, and clinical outcomes.
This longitudinal study was conducted at a 1,343-bed tertiary-care medical centre. Patients were eligible for inclusion if they were 65 years of age or older and able to communicate independently. Demographic factors, cumulative illness rating scale for geriatrics [CIRS-G] (assessing physiologic reserve), intrinsic capacity, physical resilience instrument for older adults [PRIFOR] (assessing physical resilience), and clinical frailty scale [CFS] were collected at admission. The CFS and EuroQoL 5-dimension 3-level questionnaire [EQ5D] were administered at discharge.
The mean age of the 413 patients was 76.34 ± 6.72 (52.5% female). Two conceptual models were identified and supported. Specifically, the path coefficients in the two models showed that the CIRS-G had diverse associations with each intrinsic capacity domain, and that all intrinsic capacity domains (except vitality) were significantly associated with PRIFOR. Moreover, PRIFOR was significantly associated with follow-up CFS, baseline control, and EQ5D scores.
Physiologic reserve positively correlated with the cognitive and locomotive domains of intrinsic capacity. Moreover, older patients with better intrinsic capacity may have improved physical resilience, which may lead to better clinical outcomes. Efforts to improve the intrinsic capacity and physical resilience of older patients are necessary to promote healthy ageing.
生理储备、内在能力和身体恢复力之间的关系尚未得到研究，因此需要一个包含这些健康老龄化关键决定因素的概念模型。本研究旨在使用实际数据测试一个概念模型，以确定生理储备、内在能力、身体恢复力和临床结局之间的关系。
这项纵向研究在一家拥有1343张床位的三级医疗中心进行。年龄在65岁及以上且能够独立沟通的患者符合纳入条件。在入院时收集人口统计学因素、老年累积疾病评定量表[CIRS-G]（评估生理储备）、内在能力、老年人身体恢复力工具[PRIFOR]（评估身体恢复力）和临床衰弱量表[CFS]。在出院时进行CFS和欧洲五维健康量表[EQ-5D]问卷调查。
413名患者的平均年龄为76.34±6.72岁（52.5%为女性）。确定并支持了两个概念模型。具体而言，两个模型中的路径系数表明，CIRS-G与每个内在能力领域有不同的关联，并且所有内在能力领域（活力除外）均与PRIFOR显著相关。此外，PRIFOR与随访时的CFS评分、基线对照和EQ-5D评分显著相关。
生理储备与内在能力的认知和运动领域呈正相关。此外，内在能力较好的老年患者可能具有更好的身体恢复力，这可能导致更好的临床结局。为促进健康老龄化，有必要努力提高老年患者的内在能力和身体恢复力。
