Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
Danone Nutricia Research, Utrecht, The Netherlands.
Arch Phys Med Rehabil. 2024 Oct;105(10):1854-1861. doi: 10.1016/j.apmr.2024.05.021. Epub 2024 Jun 6.
OBJECTIVE: To determine the prevalence and co-occurrence of common geriatric syndromes in geriatric rehabilitation inpatients. DESIGN: Restoring Health of Acutely Unwell Adults (RESORT) and Enhancing Muscle Power in Geriatric Rehabilitation (EMPOWER-GR) are observational, longitudinal cohorts. SETTING: Geriatric rehabilitation. PARTICIPANTS: Geriatric rehabilitation inpatients (N=1890 and N=200). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Geriatric syndromes included polypharmacy, multimorbidity (Cumulative Illness Rating Scale), cognitive impairment, depression (Hospital Anxiety and Depression Scale/Geriatric Depression Scale), malnutrition (Global Leadership Initiative on Malnutrition), functional limitation (Katz index), falls, physical frailty (Fried), and sarcopenia (European Working Group on Sarcopenia in Older People 2). RESULTS: Inpatients in RESORT (R) (N=1890, 56% females) had a median age of 83.4 years (interquartile range [IQR], 77.6-88.4) and in EMPOWER-GR (E) (N=200, 57% females) of 79.8 years (IQR, 75.0-85.9). Polypharmacy (R, 82.2%; E, 84.0%), multimorbidity (R, 90.4%; E, 85.5%), functional limitation (R, 96.0%; E, 76.5%), and frailty (R, 91.8%; E, 92.2%) were most prevalent. Most inpatients had ≥5 geriatric syndromes at admission in both cohorts (R, 70.0%; E, 72.4%); few inpatients had only 1 (R, 0.4%; E, 1.5%) or no geriatric syndrome (R, 0.2%; E, 0.0%). Geriatric syndromes did not occur in isolation (without other syndromes), except for multimorbidity (R, 1%; E, 5%), functional limitation (R, 3%; E, 2%), falls (R, 0%; E, 4%), and frailty (R, 2%; E, 5%), which occurred in isolation in some inpatients; sarcopenia did not. CONCLUSIONS: Geriatric syndromes are highly prevalent at admission to geriatric rehabilitation, with a median of 5 co-occurring syndromes. Implications for diagnosis and intervention potential should be further addressed.
目的:确定老年康复住院患者常见老年综合征的患病率和共病情况。
设计:康复成人健康恢复研究(RESORT)和增强老年康复肌肉力量研究(EMPOWER-GR)为观察性、纵向队列研究。
地点:老年康复。
参与者:老年康复住院患者(RESORT 组 N=1890,EMPOWER-GR 组 N=200)。
干预措施:无。
主要观察指标:老年综合征包括多重用药(累积疾病评分量表)、多种合并症(累积疾病评分量表)、认知障碍(医院焦虑抑郁量表/老年抑郁量表)、营养不良(全球营养领导倡议)、功能受限(Katz 指数)、跌倒、身体虚弱(Fried)和肌少症(欧洲老年人肌少症工作组 2 型)。
结果:RESORT 组(R)(N=1890,56%女性)的中位年龄为 83.4 岁(四分位间距[IQR],77.6-88.4),EMPOWER-GR 组(E)(N=200,57%女性)的中位年龄为 79.8 岁(IQR,75.0-85.9)。多重用药(R 组 82.2%;E 组 84.0%)、多种合并症(R 组 90.4%;E 组 85.5%)、功能受限(R 组 96.0%;E 组 76.5%)和虚弱(R 组 91.8%;E 组 92.2%)最为常见。两个队列中大多数住院患者入院时均有≥5 种老年综合征(R 组 70.0%;E 组 72.4%);只有少数患者(R 组 0.4%;E 组 1.5%)或无老年综合征(R 组 0.2%;E 组 0.0%)。除了多种合并症(R 组 1%;E 组 5%)、功能受限(R 组 3%;E 组 2%)、跌倒(R 组 0%;E 组 4%)和虚弱(R 组 2%;E 组 5%)外,老年综合征不会单独发生(没有其他综合征),肌少症除外。
结论:老年康复住院患者入院时老年综合征高度普遍,平均有 5 种共病。应进一步探讨诊断和干预潜力的意义。
Front Public Health. 2025-7-28