社区老年门诊患者中衰弱、疑似肌肉减少症和营养不良的共病情况：一项多中心观察性研究
Co-occurrence of Frailty, Possible Sarcopenia, and Malnutrition in Community-Dwelling Older Outpatients: A Multicentre Observational Study.
作者信息
Setiati Siti, Harimurti Kuntjoro, Fitriana Ika, Dwimartutie Noto, Istanti Rahmi, Azwar Muhammad Khifzhon, Aryana I Gusti Putu Suka, Sunarti Sri, Sudarso Agus, Ariestine Dina Aprillia, Dwipa Lazuardhi, Widajanti Novira, Riviati Nur, Mulyana Roza, Rensa Rensa, Mupangati Yudo Murti, Budiningsih Fatichati, Sari Nina Kemala
机构信息
Division of Geriatric Medicine, Department of Internal Medicine, Cipto Mangunkusumo Hospital - Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Department of Internal Medicine, Faculty of Medicine, Universitas Udayana, Denpasar, Indonesia.
出版信息
Ann Geriatr Med Res. 2025 Mar;29(1):91-101. doi: 10.4235/agmr.24.0144. Epub 2024 Dec 18.
BACKGROUND
The co-occurrence of frailty, sarcopenia, and malnutrition was well studied in inpatient and nursing home settings, which was associated with higher risk of all-cause mortality. Multicentre data in community-dwelling outpatient setting were lacking. We aimed to find the prevalence of frailty, possible sarcopenia and malnutrition, their overlap and the associated factors in community-dwelling older outpatients.
METHODS
We collected data from community-dwelling outpatients aged ≥60 years in Indonesian geriatric care centres to conduct this cross-sectional study with bivariate and multivariable analyses. Frailty, possible sarcopenia, and malnutrition diagnoses were based on FRAIL scale, Asian Working Group for Sarcopenia 2019 consensus, and Mini Nutritional Assessment Short Form, respectively.
RESULTS
The prevalence of frailty, possible sarcopenia, and malnutrition in community-dwelling older outpatients were 13.6%, 45.5%, and 5.3%, respectively. The prevalence of co-occurrence of frailty, possible sarcopenia and malnutrition was 3.3%. It was associated with transient ischemic attack (TIA) and cerebrovascular accident (odds ratio [OR]=5.53, 95% confidence interval [CI] 1.48-20.61), cognitive impairment (OR=3.70, 95% CI 1.21-11.31), and dependent functional capacity (OR=11.62, 95% CI 3.38-39.99). Overlap of three evaluated syndromes was found in 24.1%, 7.2%, and 61.3% of subjects with frailty, possible sarcopenia, and malnutrition, respectively. It was characterized by a substantial proportion of female sex, older adults with low educational attainment, diabetes mellitus, hypertension, cognitive impairment, multimorbidity, and dependent functional status.
CONCLUSION
Approximately 1 in 30 community-dwelling older outpatients had overlapping frailty, possible sarcopenia, and malnutrition. The condition is associated with TIA and cerebrovascular accident, cognitive impairment, and dependent functional capacity. Standardized screening in community-dwelling older population is necessary.
背景
衰弱、肌少症和营养不良的共病情况在住院患者和疗养院环境中已有充分研究，其与全因死亡风险较高相关。社区门诊环境中的多中心数据尚缺。我们旨在查明社区居住老年门诊患者中衰弱、可能的肌少症和营养不良的患病率、它们的重叠情况及相关因素。
方法
我们从印度尼西亚老年护理中心收集年龄≥60岁的社区居住门诊患者的数据，以进行这项采用双变量和多变量分析的横断面研究。衰弱、可能的肌少症和营养不良的诊断分别基于衰弱量表、2019年亚洲肌少症工作组共识和微型营养评定简表。
结果
社区居住老年门诊患者中衰弱、可能的肌少症和营养不良的患病率分别为13.6%、45.5%和5.3%。衰弱、可能的肌少症和营养不良共病的患病率为3.3%。其与短暂性脑缺血发作（TIA）和脑血管意外相关（比值比[OR]=5.53，95%置信区间[CI]1.48 - 20.61）、认知障碍（OR=3.70，95%CI 1.21 - 11.31）以及功能依赖（OR=11.62，95%CI 3.38 - 39.99）。在衰弱、可能的肌少症和营养不良的受试者中，分别有24.1%、7.2%和61.3%存在三种评估综合征的重叠。其特征为女性比例较高、受教育程度低的老年人、糖尿病、高血压、认知障碍、多种疾病并存以及功能依赖状态。
结论
约每30名社区居住老年门诊患者中就有1人同时存在衰弱、可能的肌少症和营养不良。这种情况与TIA和脑血管意外、认知障碍以及功能依赖相关。对社区居住老年人群进行标准化筛查很有必要。
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