School of Population Health, Faculty of Medicine & Health, University of New South Wales, Samuels Building, UNSW Sydney, NSW 2052, Australia; School of Psychology, Faculty of Science, University of New South Wales, Mathews Building, UNSW Sydney, NSW 2052, Australia; Australian Ageing Futures Institute, University of New South Wales, UNSW Sydney, NSW 2052, Australia; Neuroscience Research Australia, 139 Barker Street, Randwick, NSW 2031, Australia.
School of Psychology, Faculty of Science, University of New South Wales, Mathews Building, UNSW Sydney, NSW 2052, Australia; Australian Ageing Futures Institute, University of New South Wales, UNSW Sydney, NSW 2052, Australia; Neuroscience Research Australia, 139 Barker Street, Randwick, NSW 2031, Australia.
Maturitas. 2024 May;183:107962. doi: 10.1016/j.maturitas.2024.107962. Epub 2024 Mar 5.
To explore the prevalence of frailty, association between frailty and mortality, and transitions between frailty states in urban- and regional-living First Nations Australians.
Secondary analysis of longitudinal data from the Koori Growing Old Well Study. First Nations Australians aged 60 years or more from five non-remote communities were recruited in 2010-2012 and followed up six years later (2016-2018). Data collected at both visits were used to derive a 38-item Frailty Index (FI). The FI (range 0-1.0) was classified as robust (<0.1), pre-frail (0.1- < 0.2), mildly (0.2- < 0.3), moderately (0.3- < 0.4) or severely frail (≥0.4).
Association between frailty and mortality, examined using logistic regression and transitions in frailty (the percentage of participants who changed frailty category) during follow-up.
At baseline, 313 of 336 participants (93 %) had sufficient data to calculate a FI. Median FI score was 0.26 (interquartile range 0.21-0.39); 4.79 % were robust, 20.1 % pre-frail, 31.6 % mildly frail, 23.0 % moderately frail and 20.5 % severely frail. Higher baseline frailty was associated with mortality among severely frail participants (adjusted odds ratio 7.11, 95 % confidence interval 2.51-20.09) but not moderately or mildly frail participants. Of the 153 participants with a FI at both baseline and follow-up, their median FI score increased from 0.26 to 0.28.
Levels of frailty in this First Nations cohort are substantially higher than in similar-aged non-Indigenous populations. Screening for frailty before the age of 70 years may be warranted in First Nations Australians. Further research is urgently needed to determine the factors that are driving such high levels of frailty and propose solutions to prevent or manage frailty in this population.
探讨城市和地区居住的澳大利亚原住民第一民族中衰弱的流行率、衰弱与死亡率的关系，以及衰弱状态的转变。
对 Koori 衰老研究的纵向数据的二次分析。2010-2012 年从五个非偏远社区招募了年龄在 60 岁及以上的澳大利亚原住民第一民族，并在六年后（2016-2018 年）进行了随访。在两次访问中收集的数据用于得出 38 项衰弱指数（FI）。FI（范围 0-1.0）分为健康（<0.1）、衰弱前期（0.1-<0.2）、轻度（0.2-<0.3）、中度（0.3-<0.4）或严重衰弱（≥0.4）。
使用逻辑回归和随访期间衰弱的转变（改变衰弱类别的参与者的百分比）来评估衰弱与死亡率之间的关系。
在基线时，336 名参与者中有 313 名（93%）有足够的数据来计算 FI。中位数 FI 评分为 0.26（四分位距 0.21-0.39）；4.79%为健康，20.1%为衰弱前期，31.6%为轻度衰弱，23.0%为中度衰弱，20.5%为严重衰弱。基线时较高的衰弱程度与严重衰弱参与者的死亡率相关（调整后的优势比为 7.11，95%置信区间为 2.51-20.09），但与中度或轻度衰弱参与者无关。在基线和随访时均有 FI 的 153 名参与者中，他们的 FI 中位数从 0.26 增加到 0.28。
在这个原住民队列中，衰弱的程度大大高于年龄相似的非原住民人群。在 70 岁之前对衰弱进行筛查可能是必要的。迫切需要进一步研究，以确定导致这种高衰弱水平的因素，并提出在该人群中预防或管理衰弱的解决方案。
