印度社区老年人脆弱状态转变及其预测因素的前瞻性研究

IF 2.3 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2025-01-10 DOI:10.1016/j.cegh.2025.101919

Amruta Kulkarni, Aarti Nagarkar

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引用次数: 0

摘要

虚弱是一个复杂的概念，个体的虚弱状态会随着时间的推移而改变。了解这些转变对于预防干预和医疗保健管理至关重要。本研究调查了影响非体弱、体弱前期和体弱之间过渡的因素在印度的老年人队列。方法对317名年龄在60岁及以上的男性和女性进行平均16个月的随访。使用Fried表型测量脆性。多项回归分析评估了社会人口统计学、生活方式、功能健康、社会和其他变量与虚弱转变（恶化、改善和保持在同一状态）的关系。结果入组时平均年龄70.4岁，女性占56%。在此期间，30.6%和1.5%的健壮者分别恶化为虚弱前和虚弱类别；12%体弱多病者恶化为体弱多病，16%体弱多病者死亡或出现并发症。贫民窟居住、ADL基线损害和平衡预示着强劲的恶化。吸烟或饮酒、日常生活困难和平衡障碍（校正相对风险比[ARR]:3.05 CI: 1.05-8.86）预测体弱前期恶化。识字（ARR:3.21 CI: 1.02-10.11）和社会网络（ARR:1.10 CI: 1.03-1.16）预测虚弱前的改善。认知和ADL得分在两个方向上都与稳健性和前脆弱之间的过渡有关。结论将平衡障碍、功能障碍、读写能力、社交网络和认知能力等因素确定为衰弱过渡的潜在预测因素，为老年人的衰弱管理提供了一个有希望的前景。

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A prospective study on the transition in frailty state and its predictors in community-based older adults in India

Background

Frailty is a complex concept, and individuals' frailty status can change over time. Understanding these transitions is crucial for preventive interventions and healthcare management. This study investigates the factors influencing the transitions between non-frail, pre-frail, and frailty in a cohort of older adults in India.

Methods

A cohort of 317 men and women aged 60 years and older was followed for an average of 16 months. Frailty was measured using the Fried phenotype. Multinomial regression analysis assessed the associations of sociodemographic, lifestyle, functional health, social, and other variables with frailty transitions (worsening, improvement, and retention in the same state).

Results

The mean age on enrolment was 70.4 years, and 56 % were females. Over the period, 30.6 % and 1.5 % of robust worsened to pre-frail and frail category, respectively; 12 % of pre-frail worsened to a frail category and 16 % of frail experienced death or medical complications. Slum residence, baseline impairment of ADL, and balance predicted robust worsening. Tobacco or alcohol use, difficulty in IADL, and balance impairment (Adjusted Relative Risk ratio [ARR]:3.05 CI:1.05–8.86) predicted pre-frail worsening. Literacy (ARR:3.21 CI:1.02–10.11) and social networks (ARR:1.10 CI:1.03–1.16) predicted pre-frail improvement. Cognition and ADL scores were associated with transitions between robustness and pre-frailty in both directions.

Conclusion

Identifying factors such as impaired balance, functional difficulties, literacy, social networks, and cognitive abilities as potential predictors of frailty transition presents a promising outlook for frailty management in older adults.

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.