Newcastle University, Newcastle Upon Tyne, UK.
Northumbria Healthcare NHS Foundation Trust, Morpeth, UK.
BMC Geriatr. 2024 Feb 26;24(1):190. doi: 10.1186/s12877-024-04789-6.
Populations are ageing globally and Low- and Middle-Income Countries (LMICs) are experiencing the fastest rates of demographic change. Few studies have explored the burden of frailty amongst older people in hospital in LMICs, where healthcare services are having to rapidly adapt to align with the needs of older people. This study aimed to measure the prevalence of frailty amongst older people admitted to hospital in Tanzania and to explore their demographic and clinical characteristics.
This study had a prospective observational design. Over a six-month period, all adults ≥ 60 years old admitted to medical wards in four hospitals in northern Tanzania were invited to participate. They were screened for frailty using the Clinical Frailty Scale (CFS) and the Frailty Phenotype (FP). Demographic and clinical characteristics of interest were recorded in a structured questionnaire. These included the Barthel Index, the Identification of Elderly Africans Instrumental Activities of Daily Living (IADEA-IADL) and Cognitive (IDEA-Cog) screens, the EURO-D depression scale and Confusion Assessment Method.
540 adults aged ≥ 60 were admitted, and 308 completed assessment. Frailty was present in 66.6% using the CFS and participants with frailty were significantly older, with lower levels of education and literacy, greater disability, greater comorbidity, poorer cognition and higher levels of delirium. Using the FP, 57.0% of participants were classed as frail though a majority of participants (n = 159, 51.6%) could not be classified due to a high proportion of missing data.
This study indicates that the prevalence of frailty on medical wards in northern Tanzania is high according to the CFS. However, the challenges in operationalising the FP in this setting highlight the need for future work to adapt frailty screening tools for an African context. Future investigations should also seek to correlate frailty status with long-term clinical outcomes after admission in this setting.
全球人口老龄化，中低收入国家（LMICs）经历着人口变化最快的速度。很少有研究探讨 LMICs 中住院老年人的衰弱负担，而这些国家的医疗保健服务正不得不迅速调整，以满足老年人的需求。本研究旨在衡量坦桑尼亚住院老年人衰弱的患病率，并探讨其人口统计学和临床特征。
本研究采用前瞻性观察设计。在六个月的时间里，邀请坦桑尼亚北部四家医院的所有 60 岁以上的成年人参加。他们使用临床虚弱量表（CFS）和虚弱表型（FP）进行虚弱筛查。在一个结构化问卷中记录了感兴趣的人口统计学和临床特征。这些特征包括巴氏指数、识别非洲老年人日常生活活动工具（IADEA-IADL）和认知（IDEA-Cog）筛查、EURO-D 抑郁量表和意识模糊评估方法。
共有 540 名 60 岁以上的成年人入院，其中 308 人完成了评估。使用 CFS 时，有 66.6%的人存在虚弱，虚弱患者年龄明显较大，受教育程度和文化程度较低，残疾程度较高，共病较多，认知能力较差，谵妄程度较高。使用 FP 时，57.0%的参与者被归类为虚弱，但由于数据缺失比例较高，大多数参与者（n=159，51.6%）无法进行分类。
本研究表明，根据 CFS，坦桑尼亚北部医疗病房的衰弱患病率较高。然而，在这种情况下实施 FP 所面临的挑战突显了未来需要为非洲背景下的虚弱筛查工具进行改编。未来的研究还应试图将虚弱状况与该环境下入院后的长期临床结局相关联。
