Saha Siddhartha, Amarchand Ritvik, Kumar Rakesh, O Prabhakaran Aslesh, Rajkumar Prabu, Dutt Bhardwaj Sumit, Kanungo Suman, Gharpure Radhika, Lafond Kathryn E, Azziz-Baumgartner Eduardo, Krishnan Anand
Influenza Program, Centers for Disease Control and Prevention, New Delhi, India.
All India Institute of Medical Sciences, New Delhi, India.
PLOS Glob Public Health. 2024 Dec 31;4(12):e0003903. doi: 10.1371/journal.pgph.0003903. eCollection 2024.
We studied the relationship of frailty and acute lower respiratory infection (ALRI) among a multi-site cohort of community-dwelling older adults aged ≥60 years in India. During January 2019‒January 2020, participants completed the Edmonton Frail Scale (EFS) at baseline and every 3 months at four sites in India, with each participant completing a maximum of four surveys. Participants were categorized as non-frail (0-5 points), vulnerable (6-7 points), and frail (≥8 points) based on EFS score. Project nurses made weekly home visits to identify ALRI episodes with onset during past 7 days. We estimated adjusted hazard ratios (aHR) for having an ALRI episode within 90 days after EFS by frailty category. We also assessed risk of deterioration of frailty during 7-100 days after ALRI episode onset in terms of an increased EFS score by ≥1 point and change of frailty category. Among 5801 participants (median age 65 years, 41% males), 3568 (61·5%) were non-frail, 1507 (26%) vulnerable, and 726 (12·5%) frail at enrolment. Compared with non-frail participants, the hazard of an ALRI episode was higher among vulnerable (aHR: 1·6, (95%CI 1·3-2.0) and frail participants (aHR: 1·7, 95%CI 1·3-2·2). Participants having ALRI within the past 7-100 days were at increased risk of worsening frailty category (aOR: 1.9, 95%CI 1·3-2.8) compared to participants without an ALRI episode during the same period. The association between ALRIs and worsened frailty suggests prevention of ALRIs through vaccination and other strategies may have broad reaching health benefits for older adults.
我们在印度一个多地点队列中，对年龄≥60岁的社区居住老年人进行了衰弱与急性下呼吸道感染（ALRI）关系的研究。在2019年1月至2020年1月期间，参与者在印度四个地点的基线期及之后每3个月完成一次埃德蒙顿衰弱量表（EFS）评估，每位参与者最多完成四次调查。根据EFS评分，参与者被分为非衰弱（0 - 5分）、脆弱（6 - 7分）和衰弱（≥8分）。项目护士每周进行家访，以确定过去7天内发病的ALRI病例。我们估计了按衰弱类别划分的EFS后90天内发生ALRI病例的调整风险比（aHR）。我们还根据EFS评分增加≥1分以及衰弱类别变化，评估了ALRI发病后7 - 100天内衰弱恶化的风险。在5801名参与者（中位年龄65岁，41%为男性）中，3568名（61.5%）在入组时为非衰弱，1507名（26%）为脆弱，726名（12.5%）为衰弱。与非衰弱参与者相比，脆弱参与者（aHR：1.6，95%CI 1.3 - 2.0）和衰弱参与者（aHR：1.7，95%CI 1.3 - 2.2）发生ALRI病例的风险更高。与同期未发生ALRI病例的参与者相比，过去7 - 100天内发生ALRI的参与者衰弱类别恶化的风险增加（aOR：1.9，95%CI 1.3 - 2.8）。ALRI与衰弱恶化之间的关联表明，通过疫苗接种和其他策略预防ALRI可能对老年人有广泛的健康益处。
