Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China.
Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, 210009, China.
BMC Geriatr. 2024 Jul 3;24(1):576. doi: 10.1186/s12877-024-05173-0.
OBJECTIVES: Frailty is a prevalent geriatric condition that significantly impacts the health of older adults. This study aimed to examine the prevalence of frailty among older Chinese adults aged ≥ 65 years and to assess its association with adverse geriatric outcomes. METHOD: This study included 20,724 older adults aged ≥ 65 years in Jiangsu Province, China, utilizing a random, stratified, multistage cluster sampling approach. Frailty was assessed using the 5-item FRAIL scale. Geriatric outcomes, such as independence in activities of daily living (ADL), cognitive impairment, and frequent fall events (occurring four or more times in the preceding year), were evaluated. Logistic regression models were employed to evaluate the association between frailty and geriatric outcomes, with results presented as odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: The mean age of the participants was 73.4 ± 6.4 years. The standardized prevalence of prefrailty and frailty was 35.2% and 10.3%, respectively. Individuals identified as prefrail or frail tended to live in rural areas, have lower educational levels, be widowed, have lower incomes, and engage in less physical activity. Prefrailty and frailty were associated with an increased risk of limitations in BADL (OR: 9.62, 95% CI: 7.43-12.46; and OR: 29.25, 95% CI: 22.42-38.17, respectively) and IADL (OR: 2.54, 95% CI 2.35-2.74; and OR: 5.19, 95% CI 4.66-5.78, respectively), positive cognitive impairment screening (OR: 1.23, 95% CI: 1.16-1.31; and OR: 1.72, 95% CI: 1.56-1.91, respectively), and frequent falls (occurring four or more times in the preceding year) (OR: 3.38, 95% CI: 2.50-4.56; and OR: 8.37, 95% CI: 6.01-11.65). The association between frailty and both limitations in BADL and falls was notably more pronounced among the younger age groups (p for interaction < 0.001). CONCLUSIONS: According to the 5-item FRAIL scale, frailty was associated with limitations in BADLs and IADLs, positive cognitive impairment screening, and recent falls among older adults living in the community. Screening for frailty in younger age groups has the potential to prevent declines in physical function and falls.
目的：衰弱是一种普遍的老年疾病状况，对老年人的健康有重大影响。本研究旨在调查中国≥65 岁老年人衰弱的流行率，并评估其与不良老年结局的关系。
方法：本研究纳入了江苏省 20724 名≥65 岁的老年人，采用随机、分层、多阶段聚类抽样方法。使用 5 项 FRAIL 量表评估衰弱情况。评估了日常活动自理能力（ADL）受限、认知障碍和频繁跌倒事件（前一年发生 4 次或以上）等老年结局。采用 logistic 回归模型评估衰弱与老年结局的关系，结果以比值比（OR）和 95%置信区间（CI）表示。
结果：参与者的平均年龄为 73.4±6.4 岁。衰弱前期和衰弱的标准化患病率分别为 35.2%和 10.3%。衰弱前期和衰弱的个体更倾向于居住在农村地区，教育程度较低，丧偶，收入较低，身体活动较少。衰弱前期和衰弱与 BADL（OR：9.62，95%CI：7.43-12.46；OR：29.25，95%CI：22.42-38.17）和 IADL（OR：2.54，95%CI 2.35-2.74；OR：5.19，95%CI 4.66-5.78）受限、认知障碍阳性筛查（OR：1.23，95%CI：1.16-1.31；OR：1.72，95%CI：1.56-1.91）和频繁跌倒（前一年发生 4 次或以上）（OR：3.38，95%CI：2.50-4.56；OR：8.37，95%CI：6.01-11.65）的风险增加相关。衰弱与 BADL 和跌倒受限的关联在年龄较小的群体中更为显著（交互作用 p<0.001）。
结论：根据 5 项 FRAIL 量表，衰弱与社区老年人的 BADLs 和 IADLs 受限、认知障碍阳性筛查和近期跌倒有关。在年龄较小的人群中筛查衰弱有可能预防身体功能下降和跌倒。
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