Ponvel Pavapriya, Murukesu Resshaya Roobini, Shahar Suzana, Rivan Nurul Fatin Malek, Subramaniam Ponnusamy, Singh Devinder Kaur Ajit
Faculty of Health Sciences, Centre for Healthy Ageing and Wellness (HCARE), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Inti International University, Negeri Sembilan, Malaysia.
Rejuvenation Res. 2024 Dec;27(6):198-206. doi: 10.1089/rej.2024.0047. Epub 2024 Sep 25.
Frailty, a multifaceted syndrome, affects approximately 26% of older adults globally, yet there are limited data on the prevalence and longitudinal impact of frailty subtypes. Therefore, in this study, we aim to determine the prevalence of physical, psychological, and cognitive frailty, transitions between subtypes, and associated health determinants among Malaysian community-dwelling older adults. This study is part of the longitudinal aging study in Malaysia (LRGS Ageless and TUA). We assessed 815 older adults in 2014, with successful follow-up of 402 participants (mean age: 67.08 ± 5.38 years) after 5 years. Frailty subtypes were assessed at baseline, and transitions were evaluated at the 5-year mark. At baseline, the prevalence of older adults categorized as robust, physical frailty, cognitive frailty, and psychological frailty was 26.7%, 36.3%, 12.1%, and 16.7%, respectively, with 8.1% exhibiting concurrent psychological and cognitive frailty. Follow-up results showed that 22.9% remained robust, 46.8% experienced no change, 24.9% deteriorated (adversed), and 5.5% improved (reversed). Logistic regression analysis identified living alone ( < 0.001), increased body fat percentage ( < 0.05), increased waist circumference ( < 0.05), reduced fat-free mass ( < 0.05), decreased lower limb flexibility ( < 0.05), and declined cardiorespiratory fitness ( < 0.05) as significant predictors of frailty deterioration. Higher Mini Mental State Examination (MMSE) scores and improved Timed Up and Go and Chair Stand test results ( < 0.05) were significantly associated with the reversal of frailty subtypes ( < 0.05). Younger older adults ( < 0.001), males ( < 0.05), those with lower WHO Disability Scale scores ( < 0.05), and higher MMSE scores ( < 0.05) were significantly less likely to develop frailty subtypes. Intervention strategies that focus on combined physical, cognitive, and psychosocial functions are crucial for both reversing and preventing the progression of frailty subtypes in older adults.
衰弱是一种多方面的综合征，全球约26%的老年人受其影响，但关于衰弱亚型的患病率和纵向影响的数据有限。因此，在本研究中，我们旨在确定马来西亚社区居住老年人中身体、心理和认知衰弱的患病率、亚型之间的转变以及相关的健康决定因素。本研究是马来西亚纵向衰老研究（LRGS无龄与TUA）的一部分。我们在2014年评估了815名老年人，5年后成功随访了402名参与者（平均年龄：67.08±5.38岁）。在基线时评估衰弱亚型，并在5年时评估转变情况。在基线时，被归类为强壮、身体衰弱、认知衰弱和心理衰弱的老年人患病率分别为26.7%、36.3%、12.1%和16.7%，8.1%表现出同时存在心理和认知衰弱。随访结果显示，22.9%的人仍保持强壮，46.8%的人无变化，24.9%的人恶化（不良），5.5%的人改善（逆转）。逻辑回归分析确定独居（<0.001）、体脂百分比增加（<0.05）、腰围增加（<0.05）、去脂体重减少（<0.05）、下肢柔韧性降低（<0.05）和心肺适能下降（<0.05）是衰弱恶化的重要预测因素。较高的简易精神状态检查表（MMSE）分数以及改良的计时起立行走测试和椅子站立测试结果（<0.05）与衰弱亚型的逆转显著相关（<0.05）。年龄较小的老年人（<0.001）、男性（<0.05）、世界卫生组织残疾量表得分较低的人（<0.05）以及MMSE分数较高的人（<0.05）发生衰弱亚型的可能性显著较低。关注身体、认知和心理社会功能相结合的干预策略对于逆转和预防老年人衰弱亚型的进展至关重要。
