Jiang Yuanyuan, Wu Wenbin, Liu Hengshuo, Zhou Qi, Xi Huan
Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No.1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China.
Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No.1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China.
BMC Public Health. 2025 Aug 12;25(1):2738. doi: 10.1186/s12889-025-24133-w.
The association between living alone and frailty has not been systematically investigated in previous studies, among which inconsistent results were yielded. This study aimed to understand the association and its gender disparity in Chinese older adults undergoing hospitalisation.
This multicenter cross-sectional study included 1037 older adults aged 65 years or older. Comprehensive geriatric assessment was performed to collect information. Frailty was assessed using the FRAIL scale and the Fried Frailty Phenotype (FFP) criteria. Sociodemographic features were obtained through questionnaires. Depression was evaluated with the 2-item Patient Health Questionnaire (PHQ-2), and anxiety was evaluated with the 2-item Generalized Anxiety Disorder Questionnaire (GAD-2). Activities of daily living, chronic diseases and multimorbidity were systematically assessed by healthcare professionals. The association between living alone and frailty was investigated using logistic regression models, with potential confounders adjusted for.
171 (16.5%) older adults were living alone. The overall prevalence of frailty was 19.4% and 17.4% according to the FRAIL scale and the FFP criteria, respectively. Older adults who were living alone had a higher prevalence of frailty (28.7% by FRAIL and 24.4% by FFP) than those who were living with others (17.6% by FRAIL and 16.0% by FFP) (P < 0.01 for both criteria). Living alone was significantly associated with frailty in logistic regressions (FRAIL, OR = 1.89, 95% CI = 1.30-2.75; FFP, OR = 1.70, 95% CI = 1.13-2.53). The association was significant only in males (FRAIL: male, OR = 2.55, 95% CI = 1.55-4.21; female, OR = 1.30, 95% CI = 0.73-2.32). Similar results were observed in fully adjusted models that controlled for age, marital status, and morbidity status.
For Chinese older patients, living alone is a marker of risk for frailty, especially for men. Assessing living arrangements as an indicator to identify older inpatients at elevated risk of frailty could help guide targeted screening and supportive care.
以往研究尚未对独居与衰弱之间的关联进行系统调查，研究结果并不一致。本研究旨在了解中国住院老年人群中两者的关联及其性别差异。
这项多中心横断面研究纳入了1037名65岁及以上的老年人。进行了综合老年评估以收集信息。使用衰弱量表（FRAIL）和弗里德衰弱表型（FFP）标准评估衰弱情况。通过问卷调查获取社会人口学特征。使用两项患者健康问卷（PHQ-2）评估抑郁，使用两项广泛性焦虑障碍问卷（GAD-2）评估焦虑。医护人员对日常生活活动、慢性病和多种疾病共存情况进行了系统评估。使用逻辑回归模型研究独居与衰弱之间的关联，并对潜在混杂因素进行了调整。
171名（16.5%）老年人独居。根据FRAIL量表和FFP标准，衰弱的总体患病率分别为19.4%和17.4%。独居老年人的衰弱患病率（FRAIL量表为28.7%，FFP标准为24.4%）高于与他人同住者（FRAIL量表为17.6%，FFP标准为16.0%）（两种标准下P均<0.01）。在逻辑回归中，独居与衰弱显著相关（FRAIL量表：比值比[OR]=1.89，95%置信区间[CI]=1.30 - 2.75；FFP标准：OR = 1.70，95% CI = 1.13 - 2.53）。这种关联仅在男性中显著（FRAIL量表：男性，OR = 2.55，95% CI = 1.55 - 4.21；女性，OR = 1.30，95% CI = 0.73 - 2.32）。在控制了年龄、婚姻状况和发病情况的完全调整模型中观察到了类似结果。
对于中国老年患者，独居是衰弱风险的一个标志，尤其是对男性而言。将生活安排作为识别衰弱风险较高的老年住院患者的一个指标进行评估，有助于指导有针对性的筛查和支持性护理。
