Liang X Y, Zhou Q G, Wang L Y, Wang S L, Xie Y L, Yang X, He J Y, Zhang Z Y, Wang M C, He S X, Zhang Y Q, Chen T L, Wu X H, Wang T T, Lin H J, Chen X X, He N
Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China Yiwu Research Institute Fudan University, Yiwu 322000, China.
Taizhou Prefectural Center for Disease Control and Prevention of Zhejiang Province, Taizhou 318000, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2024 Jan 10;45(1):139-147. doi: 10.3760/cma.j.cn112338-20230720-00026.
To compare the prevalence of frailty and related factors in middle-aged and elderly people aged ≥45 years in island and mountainous areas of Taizhou, Zhejiang Province. Based on cross-sectional design, stratified cluster sampling and quota sampling methods were adopted. One administrative district was randomly selected from each of six coastal and three inland administrative districts in Taizhou during July to August, representing two different geographical terrains. In the island area (Jiaojiang District), all residents aged ≥45 years were included by cluster sampling. In the mountainous area (Xianju County), participants were selected through quota sampling, with same gender and age distributions. Data about their demographic characteristics, lifestyle and health-related factors were collected through questionnaire surveys and laboratory examinations. The prevalence of frailty was assessed using the Fried frailty phenotype scale. Hierarchical analysis and multivariate logistic regression analysis were used to compare the influencing factors of frailty. A total of 1 011 local residents were studied, in whom island and mountainous residents accounted for 48.1% (486/1 011) and 51.9% (525/1 011) respectively; men and women accounted for 45.9% (464/1 011) and 54.1% (547/1 011) respectively. Middle-aged (45-49 years), younger elderly (60-74 years), and older elderly (≥75 years) residents accounted for 38.6% (390/1 011), 44.6% (451/1 011), and 16.8% (170/1 011) respectively. The overall prevalence rate of frailty was 3.6% (36/1 011), the prevalence rate was 3.7% (17/464) in men and 3.5% (19/547) in women. The prevalence rates in age groups 45-59,60-74 years and ≥75 years were 0.3% (1/390), 2.2% (10/451), and 14.7% (25/170), respectively. The prevalence rates of frailty and pre-frailty in island area were 6.0% (29/486) and 39.1% (190/486), respectively, which was higher than those in mountainous area (1.3%, 7/525) and (30.9%, 162/525). After adjusting for potential confounding factors, the risk for frailty in island residents was significantly higher than that in mountainous residents (a=1.55,95%: 1.07-2.25,=0.019). In island area, older age (60-74 years:a=2.52,95%: 1.56-4.13; ≥75 years:a=11.65,95%:5.38-26.70), being women (a=1.94,95%: 1.20-3.17), suffering from depression (a=1.09,95%:1.02-1.17) were associated with frailty symptoms. In mountainous area, older age was also associated with an increased risk of frailty symptoms, but the value was lower than those in island area (60-74 years: a=1.74,95%:1.04-2.94;≥75 years: a=4.78,95%:2.45-9.50). Polydrug use (a=2.08,95%: 1.14-3.80) and suffering from depression (a=1.10,95%: 1.02-1.18) had significant positive association with frailty symptoms. Higher education level had significant negative association with frailty symptoms (junior high school: a=0.40,95%: 0.21-0.75; senior high school and technical secondary school: a=0.29,95%: 0.15-0.53; college or above:a=0.22,95%: 0.11-0.42). The prevalence of frailty in middle-aged and elderly community residents was significantly higher in island area than in mountainous area in Taizhou. The frailty-related factors varied with area. The elderly people (≥75 years) and women in island area had higher risk for frailty. Older age and suffering from depression were the independent risk factors for frailty. It is necessary to pay attention to the health risk factors and special environment in island area, and take comprehensive intervention measures to delay the process of debilitation and improve the quality of life of middle-aged and elderly people.
比较浙江省台州市海岛和山区45岁及以上中老年人群衰弱的患病率及相关因素。采用横断面设计,运用分层整群抽样和配额抽样方法。在7至8月期间,从台州市6个沿海行政区和3个内陆行政区中各随机抽取1个行政区,分别代表两种不同的地理地形。在海岛地区(椒江区),通过整群抽样纳入所有45岁及以上居民。在山区(仙居县),通过配额抽样选取性别和年龄分布相同的参与者。通过问卷调查和实验室检查收集他们的人口统计学特征、生活方式和健康相关因素的数据。采用Fried衰弱表型量表评估衰弱的患病率。运用分层分析和多因素logistic回归分析比较衰弱的影响因素。共研究了1011名当地居民,其中海岛居民和山区居民分别占48.1%(486/1011)和51.9%(525/1011);男性和女性分别占45.9%(464/1011)和54.1%(547/1011)。中年(45 - 49岁)、年轻老年人(60 - 74岁)和老年老年人(≥75岁)居民分别占38.6%(390/1011)、44.6%(451/1011)和16.8%(170/1011)。衰弱的总体患病率为3.6%(36/1011),男性患病率为3.7%(17/464),女性患病率为3.5%(19/547)。45 - 59岁、60 - 74岁和≥75岁年龄组的患病率分别为0.3%(1/390)、2.2%(10/451)和14.7%(25/170)。海岛地区衰弱和衰弱前期的患病率分别为6.0%(29/486)和39.1%(190/486),高于山区(1.3%,7/525)和(30.9%,162/525)。在调整潜在混杂因素后,海岛居民衰弱的风险显著高于山区居民(a = 1.55,95%CI:1.07 - 2.25,P = 0.019)。在海岛地区,年龄较大(60 - 74岁:a = 2.52,95%CI:1.56 - 4.13;≥75岁:a = 11.65,95%CI:5.38 - 26.70)、女性(a = 1.94,95%CI:1.20 - 3.17)、患有抑郁症(a = 1.09,95%CI:1.02 - 1.17)与衰弱症状相关。在山区,年龄较大也与衰弱症状风险增加相关,但比值低于海岛地区(60 - 74岁:a = 1.74,95%CI:1.04 - 2.94;≥75岁:a = 4.78,95%CI:2.45 - 9.50)。使用多种药物(a = 2.08,95%CI:1.14 - 3.80)和患有抑郁症(a = 1.10,95%CI:1.02 - 1.18)与衰弱症状呈显著正相关。较高的教育水平与衰弱症状呈显著负相关(初中:a = 0.40,95%CI:0.21 - 0.75;高中和中专:a = 0.29,95%CI:0.15 - 0.53;大专及以上:a = 0.22,95%CI:0.11 - 0.42)。台州市中老年社区居民衰弱的患病率在海岛地区显著高于山区。与衰弱相关的因素因地区而异。海岛地区的老年人(≥75岁)和女性衰弱风险较高。年龄较大和患有抑郁症是衰弱的独立危险因素。有必要关注海岛地区的健康危险因素和特殊环境,采取综合干预措施延缓衰弱进程,提高中老年人群的生活质量。