广州市老年人衰弱现状及其影响因素
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摘要
目的了解广州市老年人衰弱现状及影响因素,为衰弱管理提供依据。方法于2017年8月—2018年4月便利抽取1 217名广州市老年人开展横断面调查,采用共享型衰弱筛查工具中文版和自编一般社会人口学及健康状况与健康行为问卷收集资料。结果 1 217名老年人中处于衰弱期的占10.3%,衰弱前期占30.7%,非衰弱期占59%。有序多分类logistic回归分析结果显示,女性(OR=3.542)、高龄(OR=3.51)、收入低(OR=1.465)、独居(OR=3.404)、不能自理(OR=3.295)、患多种慢病(OR=4.718)、多重用药(OR=2.309)、尿失禁(OR=3.594)、抑郁(OR=3.27)、健康自评差(OR=2.482)是广州市老年人衰弱状况的危险因素;经常体育锻炼(OR=0.158)是广州市老年人衰弱状况的保护因素。结论广州市老年人衰弱状况应得到政策制定者和卫生保健人员的重视,应针对衰弱危险因素采取相应措施,更好地管理老年人健康。
Objective To investigate the prevalence and influencing factors of frailty among older people in Guangzhou city and to provide evidences for frailty management. Methods Totally 1 217 older people were recruited with convenient sampling in two communities and one nursing home in Guangzhou city for a cross-sectional survey between August 2017 and April 2018. We adopted a face-to-face interview with the Survey of Health, Ageing and Retirement in Europe Frailty Instrument(SHARE-FI) and grip strength measurement to screen frailty. Socio-demographic and other relevant information of the participants were collected with a self-designed questionnaire. Results Of all the participants, 10.3%, 30.7%, and 59.0% were assessed as being frail, pre-frail, and non-frail, respectively. The results of ordinal logistic regression analysis revealed that female gender(odds ratio [OR] = 3.542), at elder age(OR = 3.51), with low income(OR = 1.465), living alone(OR = 3.404), being unable to take care of oneself(OR = 3.295), suffering from several chronic diseases(OR = 4.718),having multiple medication(OR = 2.309), with urinary incontinence(OR = 3.594), with depression(OR = 3.27), and with poor self-rated health(OR = 2.482) were the risk factors of frailty and having regular physical exercise(OR = 0.158) was a protective factor against frailty among the participants. Conclusion Policymakers and healthcare providers should pay more attentions to frailty issue among elderly people in Guangzhou city and implement proper interventions specific to relevant factors in the population.
Objective To investigate the prevalence and influencing factors of frailty among older people in Guangzhou city and to provide evidences for frailty management. Methods Totally 1 217 older people were recruited with convenient sampling in two communities and one nursing home in Guangzhou city for a cross-sectional survey between August 2017 and April 2018. We adopted a face-to-face interview with the Survey of Health, Ageing and Retirement in Europe Frailty Instrument(SHARE-FI) and grip strength measurement to screen frailty. Socio-demographic and other relevant information of the participants were collected with a self-designed questionnaire. Results Of all the participants, 10.3%, 30.7%, and 59.0% were assessed as being frail, pre-frail, and non-frail, respectively. The results of ordinal logistic regression analysis revealed that female gender(odds ratio [OR] = 3.542), at elder age(OR = 3.51), with low income(OR = 1.465), living alone(OR = 3.404), being unable to take care of oneself(OR = 3.295), suffering from several chronic diseases(OR = 4.718),having multiple medication(OR = 2.309), with urinary incontinence(OR = 3.594), with depression(OR = 3.27), and with poor self-rated health(OR = 2.482) were the risk factors of frailty and having regular physical exercise(OR = 0.158) was a protective factor against frailty among the participants. Conclusion Policymakers and healthcare providers should pay more attentions to frailty issue among elderly people in Guangzhou city and implement proper interventions specific to relevant factors in the population.
引文
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[12]Dong L,Qiao X,Tian X,et al.Cross-cultural adaptation and validation of the FRAIL Scale in Chinese community-dwelling older adults[J].Journal of the American Medical Directors Association,2018,19(1):12-17.
[13]Fairhall N,Kurrle SE,Sherrington C,et al.Effectiveness of a multifactorial intervention on preventing development of frailty in pre-frail older people:study protocol for a randomised controlled trial[J].BMJ Open,2015,5(2):e7091.
[14]Fried LP,Tangen CM,Walston J,et al.Frailty in older adults:evidence for a phenotype[J].J Gerontol A Biol Sci Med Sci,2001,56(3):M146-M156.
[15]Chen CY,Wu SC,Chen LJ,et al.The prevalence of subjective frailty and factors associated with frailty in Taiwan[J].Arch Gerontol Geriatr,2010,50(Suppl 1):S43-S47.
[16]Xue Q.The frailty syndrome:definition and natural history[J].Clinics in Geriatric Medicine,2011,27(1):1-15.
[17]奚兴,郭桂芳,孙静.社区老年人衰弱状况与抑郁症状关系的研究[J].护理学杂志,2014,29(15):87-89.
[18]Serra-Prat M,Papiol M,Vico J,et al.Factors associated with frailty in community-dwelling elderly population:a cross-sectional study[J].European Geriatric Medicine,2016,7(6):531-537.
[19]Berardelli M,De Rango F,Morelli M,et al.Urinary incontinence in the elderly and in the oldest old:correlation with frailty and mortality[J].Rejuvenation Research,2013,16(3):206-211.
[20]赵雅宜,丁亚萍,李现文,等.南京市养老机构老年人衰弱现状及危险因素分析[J].中国公共卫生,2018,34(4):550-553.
[21]Fillit H,Butler RN.The frailty identity crisis[J].Journal of the American Geriatrics Society,2009,57(2):348-352.
[22]Artaza-Artabe I,Sáez-López P,Sánchez-Hernández N,et al.The relationship between nutrition and frailty:effects of protein intake,nutritional supplementation,vitamin D and exercise on muscle metabolism in the elderly.A systematic review[J].Maturitas,2016,93:89-99.
[2]Walston J,Hadley EC,Ferrucci L,et al.Research agenda for frailty in older adults:toward a better understanding of physiology and etiology:summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults[J].Journal of the American Geriatrics Society,2006,54(6):991-1001.
[3]中华医学会老年医学分会.老年患者衰弱评估与干预中国专家共识[J].中华老年医学杂志,2017,36(3):251-256.
[4]Clegg A,Young J,Iliffe S,et al.Frailty in elderly people[J].Lancet,2013,381(9868):752-762.
[5]Dent E,Lien C,Lim WS,et al.The Asia-Pacific clinical practice guidelines for the management of frailty[J].J Am Med Dir Assoc,2017,18(7):564-575.
[6]中华人民共和国国家卫生和计划生育委员会,WS/T 552-2017老年人营养不良风险评估[S].北京:国家卫生和计划生育委员会,2017.
[7]闫丁,焦璨.简版流调中心抑郁量表在老年人中的因子结构[J].中国心理卫生杂志,2016,30(9):718-720.
[8]Andresen EM,Malmgren JA,Carter WB,et al.Screening for depression in well older adults:evaluation of a short form of the CES-D(Center for Epidemiologic Studies Depression Scale)[J].Am J Prev Med,1994,10(2):77-84.
[9]Romero-Ortuno R,Walsh CD,Lawlor BA,et al.A frailty instrument for primary care:findings from the Survey of Health,Ageing and Retirement in Europe(SHARE)[J].BMC Geriatrics,2010,10(1):57.
[10]Romero-Ortuno R.The SHARE operationalized frailty phenotype:a comparison of two approaches[J].European Geriatric Medicine,2013,4(4):255-259.
[11]奚兴,郭桂芳.社区老年人衰弱现状及其影响因素研究[J].中国护理管理,2014,14(12):1315-1319.
[12]Dong L,Qiao X,Tian X,et al.Cross-cultural adaptation and validation of the FRAIL Scale in Chinese community-dwelling older adults[J].Journal of the American Medical Directors Association,2018,19(1):12-17.
[13]Fairhall N,Kurrle SE,Sherrington C,et al.Effectiveness of a multifactorial intervention on preventing development of frailty in pre-frail older people:study protocol for a randomised controlled trial[J].BMJ Open,2015,5(2):e7091.
[14]Fried LP,Tangen CM,Walston J,et al.Frailty in older adults:evidence for a phenotype[J].J Gerontol A Biol Sci Med Sci,2001,56(3):M146-M156.
[15]Chen CY,Wu SC,Chen LJ,et al.The prevalence of subjective frailty and factors associated with frailty in Taiwan[J].Arch Gerontol Geriatr,2010,50(Suppl 1):S43-S47.
[16]Xue Q.The frailty syndrome:definition and natural history[J].Clinics in Geriatric Medicine,2011,27(1):1-15.
[17]奚兴,郭桂芳,孙静.社区老年人衰弱状况与抑郁症状关系的研究[J].护理学杂志,2014,29(15):87-89.
[18]Serra-Prat M,Papiol M,Vico J,et al.Factors associated with frailty in community-dwelling elderly population:a cross-sectional study[J].European Geriatric Medicine,2016,7(6):531-537.
[19]Berardelli M,De Rango F,Morelli M,et al.Urinary incontinence in the elderly and in the oldest old:correlation with frailty and mortality[J].Rejuvenation Research,2013,16(3):206-211.
[20]赵雅宜,丁亚萍,李现文,等.南京市养老机构老年人衰弱现状及危险因素分析[J].中国公共卫生,2018,34(4):550-553.
[21]Fillit H,Butler RN.The frailty identity crisis[J].Journal of the American Geriatrics Society,2009,57(2):348-352.
[22]Artaza-Artabe I,Sáez-López P,Sánchez-Hernández N,et al.The relationship between nutrition and frailty:effects of protein intake,nutritional supplementation,vitamin D and exercise on muscle metabolism in the elderly.A systematic review[J].Maturitas,2016,93:89-99.