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老年人衰弱分布及其影响因素的初步研究

         

摘要

Objective To research the distribution and influencing factors of the frailty and its associated variables among the older adult.Methods A total of 106 elders under physical examination in Outpatient Department of our hospital were selected and investigated.Frailty pheynotype were assessed by five components of frailty (low weight,weakness,exhaustion,slowness,low physical activity).Frailty status was defined as meeting the criteria for at least three of the five components of frailty.Comprehensive geriatric assessment (CGA) including information of general condition,coexistent diseases,drug usage,geriatric syndrome (such as falling,urinary in incontinence,constipation,pain),nutrition,sleep status,activities of daily living,depressive symptoms,and cognitive function.Associations between participants' characteristics and frailty status were examined using multinomial logistic regression models.Results The prevalence of robustness,pre-frailty,and frailty was 26 (24.5%),65 (61.3%),and 15 (14.2%),respectively.The frequency of frailty was 18.2% among ≥80 years older and was 9.8% in those <80 years.Frailty was more frequent in those with comorbidity (93.3%) or disability(60.0%).The frequency of frailty was higher in those elder,lower body mass index (BMI),poor hearing,disability,urinary incontinence,poor sleep,cognitive impairment,malnutrition,polypharmacy and other comorbidity such as diabetes and cancer(all P < 0.05).The logistic regression showed polypharmacy was significantly associated with pre-frailty (OR =2.376,P <0.05) while cognitive impairment was related with frailty (OR =2.079,P < 0.05).Conclusion The prevalence of prefrailty is worth drawing attention as well as frailty.Frail old people are more easily complicated with disability and comorbidity.Lower cognitive function and polypharmacy are independent determinants of frailty.%目的 研究老年人衰弱发生情况以及探讨其影响因素.方法 收集医院门诊体检资料完整的106例老年人,平均年龄(79.5±7.6)岁.衰弱采用Freid表型定义评估,包括体质量下降、疲乏、走路速度缓慢、握力低、身体活动量低5个指标,符合3项或3项以上的被确定为衰弱,1~2项符合的为衰弱前期,0项为无衰弱.老年人综合评估包括一般情况、疾病以及用药情况、老年综合征、营养风险、认知状态、日常生活活动能力、抑郁、睡眠等.结果 106例老年人中无衰弱老年人26例(24.5%)、衰弱前期老年人65例(61.3%)、衰弱老年人15例(14.2%).其中,< 80岁5例(9.8%)衰弱,≥80岁10例(18.2%)为衰弱;衰弱老年人中9例(60.0%)发生失能,14例(93.3%)存在共病.衰弱老年人较非衰弱老年人年龄大、体质量指数(BMI)低、听力下降,患有尿失禁、失眠、营养不良比例高,并且日常生活能力下降、认知功能下降,合并糖尿病和恶性肿瘤以及多重用药明显(均P <0.05).Logistic回归分析显示,多重用药与衰弱前期独立相关(OR=2.376,P<0.05),认知障碍与衰弱独立相关(OR =2.079,P<0.05).结论 老年人衰弱前期和衰弱均应受重视,衰弱常与失能、共病并存.影响老年人衰弱程度的主要因素为认知障碍和多重用药.

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