J Li, K Kinoshita, M Yasuoka, K Maeda, M Takemura, Y Matsui, H Arai, S Satake
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引用次数: 0
摘要
研究目的本研究旨在为评估内在能力（IC）的临床意义提供证据：设计：纵向研究：参与者351名年龄≥65岁的无残疾门诊患者：不良健康后果是不良健康后果的综合，包括死亡率、急诊住院、入住疗养院、新的长期护理证明或病情加重。我们使用世界卫生组织 ICOPE 手册中的评估量表，根据五个 IC 领域创建了一个综合得分，并通过确证因子分析确定了每个领域的权重：IC综合得分与1年内的不良健康结果呈反向关系；经多变量调整后，最高与最低三分位数的几率比（95%置信区间）分别为0.20（0.09-0.41），IC得分每增加1分的几率比（95%置信区间）分别为0.63（0.48-0.83）。在特定不良健康结果方面也观察到类似的关联，但在死亡率方面没有观察到：IC与老年门诊患者随后的不良健康结果呈反向关系，这表明IC在常规老年医学实践中具有预后价值。考虑到样本量有限，我们的研究结果还需进一步证实。
Intrinsic Capacity and Its Association with Adverse Health Outcomes in Older Japanese Outpatients.
Objectives: This study aimed to provide evidence regarding the clinical significance of assessing intrinsic capacity (IC).
Design: Longitudinal study.
Setting: Frailty clinic.
Participants: 351 disability-free outpatients aged ≥65 years.
Measurements: Adverse health outcomes were a composite of adverse health outcomes, including mortality, emergency hospitalization, nursing home placement, and new certification or exacerbation for long-term care. We created a composite score based on five IC domains using assessment scales from the WHO ICOPE handbook, with the weights for each domain determined through confirmatory factor analysis.
Results: The composite score of IC was inversely associated with adverse health outcomes within 1-year; the multivariable-adjusted odds ratio (95% confidence interval) was 0.20 (0.09-0.41) for the highest versus lowest tertile, and 0.63 (0.48-0.83) for each 1-point increment in IC score, respectively. Similar associations were observed for specific adverse health outcome, but not for mortality.
Conclusion: IC was inversely associated with subsequent adverse health outcomes in older outpatients, suggesting its prognostic value in routine geriatric practices. Considering the limited sample size, our findings need to be further confirmed.
期刊介绍：
The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons. The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).
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