Shamsalinia Abbas, Hosseini Seyed Reza, Bijani Ali, Ghadimi Reza, Saadati Kiyana, Kordbageri Mohammad Reza, Ghaffari Fatemeh
Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
Social Determinants of Health (SDH) Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
BMC Geriatr. 2024 Aug 8;24(1):665. doi: 10.1186/s12877-024-05268-8.
Early diagnosis and control of risk factors affecting frailty syndrome (FS) in older adults may lead to changes in the health/disease process, prevention of disability and dependency in the older adults, and reduction of health care costs and mortality rates. The aim of this study was to determine the predictive role of CVD risk factors and FS in community-dwelling older adults of Amirkola city in Iran.
This descriptive-analytic cross-sectional study is part of the second phase of the Amirkola Health and Aging Project (AHAP) cohort study conducted since 2011 on all individuals ≥ 60 years in the city of Amirkola in northern Iran. Totally, 1000 older adults were included in the study and divided into three groups: frail (n = 299), pre-frail (n = 455), and non-frail (n = 246) older adults. In the present study, age ≥ 60 years, female sex, fasting blood sugar (FBS) ≥ 126 mg/dl, affected diabetes mellitus (DM), body mass index (BMI) ≥ 27 kg/m², waist circumference (WC) or abdominal obesity > 102 cm in men and > 88 cm in women, low-density lipoprotein (LDL) > 100 mg/dl, triglyceride > 150 mg/dl, cholesterol > 200 mg/dl, high-density lipoprotein (HDL) < 40 mg/dl and blood pressure (BP) > 90/140 mmHg, uric acid > 7 mg/dl and a positive smoking history were considered CVD risk factors.
The results showed that with each centimeter increase in WC, the odds of frailty compared with non-frailty was 79% higher, and the odds of frailty compared with pre-frailty was 1.43 times higher in older adults. In addition, the prevalence of pre-frailty compared with non-frailty, pre-frailty, and non-frailty was 10.59 times, 6.08 times, and 73.83 times higher in older individuals > 84 years old, respectively. The results of the present study indicated that the prevalence of pre-frailty compared with non-frailty, frailty compared with pre-frailty, and frailty compared with non-frailty was 2.86 times, 3.01 times, and 14.83 times higher in older adults women, respectively. The comparison between frail and non-frail groups represented that in DM older adults, the prevalence of frailty compared with non-frailty was 1.84 times higher and that of frailty compared with pre-frailty was 98% higher. The older adults with an FBS ≥ 126 mg/dl were 53% more likely to become frail, and with each unit increase in uric acid, the odds of becoming frail increased 2.05 times compared with non-frail older adults, and pre-frail compared with non-frail increased 99%.
The results demonstrated that CVD risk factors predictive of FS included central obesity, age > 84 years, female sex, DM, FBS ≥ 126, and uric acid > 7. This problem highlights the need for preventive strategies in the older adults who are simultaneously vulnerable to CVD and frailty.
早期诊断并控制影响老年人衰弱综合征（FS）的风险因素，可能会改变健康/疾病进程，预防老年人残疾和失能，降低医疗成本和死亡率。本研究旨在确定心血管疾病（CVD）风险因素和FS在伊朗阿米科拉市社区老年人中的预测作用。
这项描述性分析横断面研究是阿米科拉健康与衰老项目（AHAP）队列研究第二阶段的一部分，该队列研究自2011年起对伊朗北部阿米科拉市所有60岁及以上个体开展。本研究共纳入1000名老年人，分为三组：衰弱老年人（n = 299）、衰弱前期老年人（n = 455）和非衰弱老年人（n = 246）。在本研究中，年龄≥60岁、女性、空腹血糖（FBS）≥126 mg/dl、患糖尿病（DM）、体重指数（BMI）≥27 kg/m²、腰围（WC）或腹部肥胖（男性>102 cm，女性>88 cm）、低密度脂蛋白（LDL）>100 mg/dl、甘油三酯>150 mg/dl、胆固醇>200 mg/dl、高密度脂蛋白（HDL）<40 mg/dl、血压（BP）>90/140 mmHg、尿酸>7 mg/dl以及有吸烟史被视为CVD风险因素。
结果显示，WC每增加1厘米，老年人与非衰弱相比衰弱的几率高79%，与衰弱前期相比衰弱的几率高1.43倍。此外，84岁以上老年人中，与非衰弱相比衰弱前期的患病率分别高10.59倍、与衰弱前期相比高6.08倍、与非衰弱相比高73.83倍。本研究结果表明，与非衰弱相比衰弱前期的患病率、与衰弱前期相比衰弱的患病率、与非衰弱相比衰弱的患病率，在老年女性中分别高2.86倍、3.01倍和14.83倍。衰弱组与非衰弱组的比较表明，在患DM的老年人中，与非衰弱相比衰弱的患病率高1.84倍，与衰弱前期相比衰弱的患病率高98%。FBS≥126 mg/dl的老年人衰弱的可能性高53%，尿酸每增加一个单位，与非衰弱老年人相比衰弱的几率增加2.05倍，与非衰弱相比衰弱前期增加99%。
结果表明，预测FS的CVD风险因素包括中心性肥胖、年龄>84岁、女性、DM、FBS≥126以及尿酸>7。这一问题凸显了对同时易患CVD和衰弱的老年人采取预防策略的必要性。
