Benjamin Seligman MD, PhD, Katherine D. Wysham MD, Troy Shahoumian MPH, PhD, Ariela R. Orkaby MD, MPH, Matthew Bidwell Goetz MD, Thomas F. Osborne MD, Valerie A. Smith DrPH, Matthew L. Maciejewski PhD, Denise M. Hynes MPH, PhD, RN, Edward J. Boyko MD, MPH, George N. Ioannou MD, MS
{"title":"COVID-19 老年幸存者体弱程度的变化。","authors":"Benjamin Seligman MD, PhD, Katherine D. Wysham MD, Troy Shahoumian MPH, PhD, Ariela R. Orkaby MD, MPH, Matthew Bidwell Goetz MD, Thomas F. Osborne MD, Valerie A. Smith DrPH, Matthew L. Maciejewski PhD, Denise M. Hynes MPH, PhD, RN, Edward J. Boyko MD, MPH, George N. Ioannou MD, MS","doi":"10.1111/jgs.19255","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>COVID-19 survivors are at greater risk for new medical conditions. Among older adults, where multimorbidity and functional impairment are common, frailty measurement provides a tool for understanding how infection impacts future health beyond a one-disease-at-a-time approach. We investigated whether COVID-19 was associated with change in frailty among older Veterans.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Data were from the Veterans Affairs (VA) COVID-19 Observational Research Collaboratory, which extracted VA medical record data. We included Veterans who had COVID-19 from March 1, 2020, to April 30, 2021 and matched uninfected controls. We excluded those <50 years at index or did not survive 12 months after. Frailty was assessed at the index date and 12 months using the VA Frailty Index (VA-FI).</p>\n \n <p>We assessed the number of new VA-FI deficits over 12 months. Analysis was done by negative binomial regression adjusted for age, gender, race, ethnicity, and BMI. Coefficients are given as the ratio of the mean number of new deficits in COVID-19 cases versus controls during follow-up.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>We identified 91,338 COVID-19-infected Veterans and an equal number of matched controls. Median (IQR) age was 68.9 years (60.3–74.2), 5% were female, 71% were White, and baseline VA-FI was 0.16 (0.10, 0.26). Median (IQR) number of new deficits at 1 year was 1 (0–2) for infected and 0 (0–1) for uninfected controls. After adjustment, those with COVID-19 accrued 1.54 (95% CI 1.52–1.56) times more deficits than those who did not. The five most common new deficits were fatigue (9.7%), anemia (6.8%), muscle atrophy (6.5%), gait abnormality (6.2%), and arthritis (5.8%).</p>\n </section>\n \n <section>\n \n <h3> Discussion</h3>\n \n <p>We found a greater increase in frailty among older Veterans with COVID-19 compared with matched uninfected controls, suggesting that COVID-19 infection has long-term implications for vulnerability and disability among older adults. Functional impairments such as fatigue, impaired mobility, and joint pain may warrant specific attention in this population.</p>\n </section>\n </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"72 12","pages":"3800-3809"},"PeriodicalIF":4.3000,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Change in frailty among older COVID-19 survivors\",\"authors\":\"Benjamin Seligman MD, PhD, Katherine D. Wysham MD, Troy Shahoumian MPH, PhD, Ariela R. Orkaby MD, MPH, Matthew Bidwell Goetz MD, Thomas F. Osborne MD, Valerie A. Smith DrPH, Matthew L. Maciejewski PhD, Denise M. Hynes MPH, PhD, RN, Edward J. Boyko MD, MPH, George N. Ioannou MD, MS\",\"doi\":\"10.1111/jgs.19255\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>COVID-19 survivors are at greater risk for new medical conditions. Among older adults, where multimorbidity and functional impairment are common, frailty measurement provides a tool for understanding how infection impacts future health beyond a one-disease-at-a-time approach. We investigated whether COVID-19 was associated with change in frailty among older Veterans.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Data were from the Veterans Affairs (VA) COVID-19 Observational Research Collaboratory, which extracted VA medical record data. We included Veterans who had COVID-19 from March 1, 2020, to April 30, 2021 and matched uninfected controls. We excluded those <50 years at index or did not survive 12 months after. Frailty was assessed at the index date and 12 months using the VA Frailty Index (VA-FI).</p>\\n \\n <p>We assessed the number of new VA-FI deficits over 12 months. Analysis was done by negative binomial regression adjusted for age, gender, race, ethnicity, and BMI. Coefficients are given as the ratio of the mean number of new deficits in COVID-19 cases versus controls during follow-up.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>We identified 91,338 COVID-19-infected Veterans and an equal number of matched controls. Median (IQR) age was 68.9 years (60.3–74.2), 5% were female, 71% were White, and baseline VA-FI was 0.16 (0.10, 0.26). Median (IQR) number of new deficits at 1 year was 1 (0–2) for infected and 0 (0–1) for uninfected controls. After adjustment, those with COVID-19 accrued 1.54 (95% CI 1.52–1.56) times more deficits than those who did not. The five most common new deficits were fatigue (9.7%), anemia (6.8%), muscle atrophy (6.5%), gait abnormality (6.2%), and arthritis (5.8%).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Discussion</h3>\\n \\n <p>We found a greater increase in frailty among older Veterans with COVID-19 compared with matched uninfected controls, suggesting that COVID-19 infection has long-term implications for vulnerability and disability among older adults. Functional impairments such as fatigue, impaired mobility, and joint pain may warrant specific attention in this population.</p>\\n </section>\\n </div>\",\"PeriodicalId\":17240,\"journal\":{\"name\":\"Journal of the American Geriatrics Society\",\"volume\":\"72 12\",\"pages\":\"3800-3809\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-11-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the American Geriatrics Society\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jgs.19255\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Geriatrics Society","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jgs.19255","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
COVID-19 survivors are at greater risk for new medical conditions. Among older adults, where multimorbidity and functional impairment are common, frailty measurement provides a tool for understanding how infection impacts future health beyond a one-disease-at-a-time approach. We investigated whether COVID-19 was associated with change in frailty among older Veterans.
Methods
Data were from the Veterans Affairs (VA) COVID-19 Observational Research Collaboratory, which extracted VA medical record data. We included Veterans who had COVID-19 from March 1, 2020, to April 30, 2021 and matched uninfected controls. We excluded those <50 years at index or did not survive 12 months after. Frailty was assessed at the index date and 12 months using the VA Frailty Index (VA-FI).
We assessed the number of new VA-FI deficits over 12 months. Analysis was done by negative binomial regression adjusted for age, gender, race, ethnicity, and BMI. Coefficients are given as the ratio of the mean number of new deficits in COVID-19 cases versus controls during follow-up.
Results
We identified 91,338 COVID-19-infected Veterans and an equal number of matched controls. Median (IQR) age was 68.9 years (60.3–74.2), 5% were female, 71% were White, and baseline VA-FI was 0.16 (0.10, 0.26). Median (IQR) number of new deficits at 1 year was 1 (0–2) for infected and 0 (0–1) for uninfected controls. After adjustment, those with COVID-19 accrued 1.54 (95% CI 1.52–1.56) times more deficits than those who did not. The five most common new deficits were fatigue (9.7%), anemia (6.8%), muscle atrophy (6.5%), gait abnormality (6.2%), and arthritis (5.8%).
Discussion
We found a greater increase in frailty among older Veterans with COVID-19 compared with matched uninfected controls, suggesting that COVID-19 infection has long-term implications for vulnerability and disability among older adults. Functional impairments such as fatigue, impaired mobility, and joint pain may warrant specific attention in this population.
期刊介绍：
Journal of the American Geriatrics Society (JAGS) is the go-to journal for clinical aging research. We provide a diverse, interprofessional community of healthcare professionals with the latest insights on geriatrics education, clinical practice, and public policy—all supporting the high-quality, person-centered care essential to our well-being as we age. Since the publication of our first edition in 1953, JAGS has remained one of the oldest and most impactful journals dedicated exclusively to gerontology and geriatrics.
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