老年人衰弱的影响因素分析
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摘要
目的探索老年人衰弱的影响因素。方法从东莞市大朗镇随机抽取8个社区,采用项目开发的衰弱指数量表调查符合条件的老年人。采用x~2检验进行单因素分析,有序多分类Logistic回归进行多因素分析。结果单因素分析结果显示,不同人口学特点、家庭关系、经济情况及生活方式的老人衰弱情况分布有差异,且差异均有统计学意义(均有P <0. 05)。多因素分析显示,低年龄(OR=0. 13,P <0. 001)、男性(OR=0. 65,P=0. 012)、每天锻炼身体(OR=0. 76,P=0. 049)是老年人衰弱的保护因素。未接受教育(OR=2. 42,P <0. 001)、每月见到子女次数较少(OR=1. 82,P=0. 035)、以养老金为主要经济来源(OR=1. 59,P <0. 001)、低体力活动水平(OR=2. 18,P <0. 001)及不进行社会参与活动(OR=1. 41,P=0. 004)是衰弱发生的危险因素。结论年龄、性别、受教育程度、每月见到子女次数、经济来源、锻炼身体频率、体力活动水平及社会参与情况是老年人衰弱的影响因素。
Objective To explore influencing factors of the elderly's frailty. Methods Eight communities were randomly selected from Dalang Town,Dongguan City,and all the eligible elderly people were investigated using the self-developed frailty index. Univariate analysis was performed using thex~2 test,and multivariate analysis was performed by ordinal multi-class Logistic regression. Results Univariate analysis showed that there were significant differences in the distribution of frailty conditions among different demographic characteristics,family relationships,economic situation and lifestyle( all P <0. 05). Multivariate analysis showed that younger age( OR = 0. 13,P < 0. 001),male( OR = 0. 65,P =0. 012),and daily exercise( OR = 0. 76,P = 0. 049) were protective factors for frailty of the elderly. Illiterate( OR = 2. 42,P < 0. 001),fewer times to see children per month( OR = 1. 82,P = 0. 035),pension funds as the main economic source( OR = 1. 59,P < 0. 001),low level of physical activity( OR =2. 18,P < 0. 001) and none social participation( OR = 1. 41,P = 0. 004) were risk factors of frailty.Conclusion Age,gender,education level,times to see children per month,economic source,exercise frequency,physical activity level and social participation are the influencing factors of frailty of the elderly.
Objective To explore influencing factors of the elderly's frailty. Methods Eight communities were randomly selected from Dalang Town,Dongguan City,and all the eligible elderly people were investigated using the self-developed frailty index. Univariate analysis was performed using thex~2 test,and multivariate analysis was performed by ordinal multi-class Logistic regression. Results Univariate analysis showed that there were significant differences in the distribution of frailty conditions among different demographic characteristics,family relationships,economic situation and lifestyle( all P <0. 05). Multivariate analysis showed that younger age( OR = 0. 13,P < 0. 001),male( OR = 0. 65,P =0. 012),and daily exercise( OR = 0. 76,P = 0. 049) were protective factors for frailty of the elderly. Illiterate( OR = 2. 42,P < 0. 001),fewer times to see children per month( OR = 1. 82,P = 0. 035),pension funds as the main economic source( OR = 1. 59,P < 0. 001),low level of physical activity( OR =2. 18,P < 0. 001) and none social participation( OR = 1. 41,P = 0. 004) were risk factors of frailty.Conclusion Age,gender,education level,times to see children per month,economic source,exercise frequency,physical activity level and social participation are the influencing factors of frailty of the elderly.
引文
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[12]黄斯梅,黄荟森,蒙明虑,等.广西壮族自治区高中及中职在校生戊型肝炎病毒Ig G抗体阳性率的调查[J].中华疾病控制杂志,2018,22(5):535-537.DOI:10.16462/j.cnki.zhjbkz.2018.05.024.Huang SM,Huang HS,Meng ML,et al,A sampling survey for the prevalence of anti HEV-IgG in the students of high schools and secondary vocational schools in Guangxi Zhuang Autonomous Region[J].Chin J Dis Control Prev,2018,22(5):535-537.DOI:10.16462/j.cnki.zhjbkz.2018.05.024.
[13]Collard RM,Boter H,Schoevers RA,et al.Prevalence of frailty in community-dwelling older persons:a systematic review[J].JAn Geriats Soc,2012,60(8):1487-1492.DOI:10.1111/j.1532-5415.2012.04054.x.
[14]Xue QL.The frailty syndrome:definition and natural history[J].Clin Geriatr Med,2011,27(1):1-15.DOI:10.1016/j.cger.2010.08.009.
[15]Liu LK,Lee WJ,Chen LY,et al.Association between Frailty,osteoporosis,falls and hip fractures among community-dwelling people aged 50 years and older in taiwan:results from I-Lan longitudinal aging study[J].PLo S One,2015,10(9):e0136968.DOI:10.1371/journal.pone.0136968.
[16]孙凯旋,刘永兵,薛谨,等.基于老年综合评估体系构建的衰弱指数模型在老年住院患者中的应用[J].中华老年病研究电子杂志,2017,4(2):43-47.DOI:10.3877/cma.j.issn.2095-8757.2017.02.008.Sun KX,Liu YB,Xue J,et al.Application of frailty index based on a comprehensive geriatric assessment in hospitalized elderly patients[J].Chin J Geiatrics Res(Electronic Edition),2017,4(2):43-47.DOI:10.3877/cma.j.issn.2095-8757.2017.02.008.
[17]王坤,陈长香,李淑杏.石家庄某社区老年人衰弱现状及影响因素[J].中国公共卫生,2018,34(2):196-198.DOI:10.11847/zgggws1114001.Wang K,Chen CX,Li SX.Prevalence and influencing factors of frailty among community elderly people in Shijiazhuang city[J].Chin J Public Health,2018,34(2):196-198.DOI:10.11847/zgggws1114001.
[18]Jürschik P,Nunin C,BotiguéT,et al.Prevalence of frailty and factors associated with frailty in the elderly population of Lleida,Spain:the FRALLE survey[J].Arch Gerontol Geriatr,2012,55(3):625-631.DOI:10.1016/j.archger.2012.07.002.
[19]Ferreira CB,Teixeira P,Alves GDS,et al.Effects of a 12-week exercise training program on physical function in institutionalized frail elderly[J].J Aging Res,2018,2018(1):1-8.DOI:10.1155/2018/7218102.
[20]Theou O,Stathokostas L,Roland KP,et al.The effectiveness of exercise interventions for the management of frailty:a systematic review[J].J Aging Res,2011,2011(3):569194.DOI:10.4061/2011/569194.
[21]Cesari M,Vellas B,Hsu FC,et al.A physical activity intervention to treat the frailty syndrome in older persons-results from the LIFE-P study[J].Journals of Gerontology,2015,70(2):216-22.DOI:10.1093/gerona/glu099.
[22]Eyigor S,Kutsal YG,Duran E,et al.Frailty prevalence and related factors in the older adult-FrailTURK Project[J].Age,2015,37(3):50.DOI:10.1007/s11357-015-9791-z.
[2]孙凯旋,刘永兵,薛谨,等.住院老年衰弱综合征患者与生命质量关系的调查分析[J].国际护理学杂志,2018,37(1):41-45.DOI:10.3760/cma.j.issn.1673-4351.2018.01.011.Sun KX,Liu YB,Xue J,et al.The investigation and analysis of the relationship between patients with senile asthe-nia syndrome and the quality of life[J].Int J Nurs,2018,37(1):41-45.DOI:10.3760/cma.j.issn.1673-4351.2018.01.011.
[3]Song XW,Mitnitski A,Rockwood K.Prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation[J].J Am Geriatri Soc,2010,58(4):681-687.DOI:10.1111/j.1532-5415.2010.02764.x.
[4]Singh M,Stewart R,While H.Importance of frailty in patients with cardiovascular disease[J].Eur Heart J,2014,35(26):1726.DOI:10.1093/eurheartj/ehu197.
[5]Wyrko Z.Frailty at the front door[J].Clin Med,2015,15(4):377-381.DOI:10.7861/clinmedicine.15-4-377.
[6]Tarazona-Santabalbina FJ,Gómez-Cabrera MC,Pérez-Ros P,et al.A multicomponent exercise intervention that reverses frailty and improves cognition,emotion,and social networking in the community-dwelling frail elderly:A Randomized Clinical Trial[J].JAm Med Dir Assoc,2016,17(5):426-433.DOI:10.1016/j.jamda.2016.01.019.
[7]Cameron ID,Fairhall N,Langron C,et al.A multifactorial interdisciplinary intervention reduces frailty in older people:randomized trial[J].BMC Medicine,2013,11(1):65.DOI:10.1186/1741-7015-11-65.
[8]Kim H,Suzuki T,Kim M,et al.Effects of exercise and milk fat globule membrane(MFGM)supplementation on body composition,physical function,and hematological parameters in community-dwelling frail japanese women:a randomized double Blind,Placebo-Controlled,Follow-Up Trial[J].PLo S One,2015,10(2):e0116256.DOI:10.1371/journal.pone.0116256.
[9]罗如珍,杨洋,张春梅,等.社区老年人衰弱水平及影响因素研究[J].中国实用护理杂志,2017,33(15):1169-1173.DOI:10.3760/cma.j.issn.1672-7088.2017.15.012.Luo RZ,Yang Y,Zhang CM,et al.Study on the frailty level and influencing factors of elderly people in community[J].China JPra Nurs,2017,33(15):1169-1173.DOI:10.3760/cma.j.issn.1672-7088.2017.15.012.
[10]孟丽,谭潇,石婧,等.老年人衰弱分布及其影响因素的初步研究[J].中国临床保健杂志,2017,20(5):481-485.DOI:10.3969/J.issn.1672-6790.2017.05.001.Meng L,Tan X,Shi Q,et al.A preliminary study on the distribution of frailty in the elderly and its influencing factors[J].Chinese Journal of Clinical Healthcare,2017,20(5):481-485.DOI:10.3969/J.issn.1672-6790.2017.05.001.
[11]詹思延.流行病学[M].第8版.2017,北京:人民卫生出版社.42-47.Zhan SY.Epidemiology[M].Edition 8.2017,Beijing:people’s health publishing house.42-47.
[12]黄斯梅,黄荟森,蒙明虑,等.广西壮族自治区高中及中职在校生戊型肝炎病毒Ig G抗体阳性率的调查[J].中华疾病控制杂志,2018,22(5):535-537.DOI:10.16462/j.cnki.zhjbkz.2018.05.024.Huang SM,Huang HS,Meng ML,et al,A sampling survey for the prevalence of anti HEV-IgG in the students of high schools and secondary vocational schools in Guangxi Zhuang Autonomous Region[J].Chin J Dis Control Prev,2018,22(5):535-537.DOI:10.16462/j.cnki.zhjbkz.2018.05.024.
[13]Collard RM,Boter H,Schoevers RA,et al.Prevalence of frailty in community-dwelling older persons:a systematic review[J].JAn Geriats Soc,2012,60(8):1487-1492.DOI:10.1111/j.1532-5415.2012.04054.x.
[14]Xue QL.The frailty syndrome:definition and natural history[J].Clin Geriatr Med,2011,27(1):1-15.DOI:10.1016/j.cger.2010.08.009.
[15]Liu LK,Lee WJ,Chen LY,et al.Association between Frailty,osteoporosis,falls and hip fractures among community-dwelling people aged 50 years and older in taiwan:results from I-Lan longitudinal aging study[J].PLo S One,2015,10(9):e0136968.DOI:10.1371/journal.pone.0136968.
[16]孙凯旋,刘永兵,薛谨,等.基于老年综合评估体系构建的衰弱指数模型在老年住院患者中的应用[J].中华老年病研究电子杂志,2017,4(2):43-47.DOI:10.3877/cma.j.issn.2095-8757.2017.02.008.Sun KX,Liu YB,Xue J,et al.Application of frailty index based on a comprehensive geriatric assessment in hospitalized elderly patients[J].Chin J Geiatrics Res(Electronic Edition),2017,4(2):43-47.DOI:10.3877/cma.j.issn.2095-8757.2017.02.008.
[17]王坤,陈长香,李淑杏.石家庄某社区老年人衰弱现状及影响因素[J].中国公共卫生,2018,34(2):196-198.DOI:10.11847/zgggws1114001.Wang K,Chen CX,Li SX.Prevalence and influencing factors of frailty among community elderly people in Shijiazhuang city[J].Chin J Public Health,2018,34(2):196-198.DOI:10.11847/zgggws1114001.
[18]Jürschik P,Nunin C,BotiguéT,et al.Prevalence of frailty and factors associated with frailty in the elderly population of Lleida,Spain:the FRALLE survey[J].Arch Gerontol Geriatr,2012,55(3):625-631.DOI:10.1016/j.archger.2012.07.002.
[19]Ferreira CB,Teixeira P,Alves GDS,et al.Effects of a 12-week exercise training program on physical function in institutionalized frail elderly[J].J Aging Res,2018,2018(1):1-8.DOI:10.1155/2018/7218102.
[20]Theou O,Stathokostas L,Roland KP,et al.The effectiveness of exercise interventions for the management of frailty:a systematic review[J].J Aging Res,2011,2011(3):569194.DOI:10.4061/2011/569194.
[21]Cesari M,Vellas B,Hsu FC,et al.A physical activity intervention to treat the frailty syndrome in older persons-results from the LIFE-P study[J].Journals of Gerontology,2015,70(2):216-22.DOI:10.1093/gerona/glu099.
[22]Eyigor S,Kutsal YG,Duran E,et al.Frailty prevalence and related factors in the older adult-FrailTURK Project[J].Age,2015,37(3):50.DOI:10.1007/s11357-015-9791-z.