老年住院患者躯体衰弱和认知衰弱状况及其影响因素研究  

Physical and Cognitive Frailty in Hospitalized Elderly and the Influencing Factors

作　　者：王姣锋[1,4] 纪雪莹 崔月 李瑾[1] 杜丽侠[1] 张艳 俞卓伟[1] 陈洁[1,3,4] 保志军[1,3,4] Wang Jiaofeng;Ji Xueying;Cui Yue;Li Jin;Du Lixia;Zhang Yan;Yu Zhuowei;Chen Jie;Bao Zhijun(Department of Geriatrics, Huadong Hospital Affiliated to Fudan University, Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai 200040;Shanghai Medical College of Fudan University, Shanghai, 200030;Department of Gastroenterology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040;National Clinical Research Center for Aging and Medicine, Huadong Hospital Affiliated to Fudan University, 200040, P. R. China.)

机构地区：[1]复旦大学附属华东医院老年科,上海市老年医学临床重点实验室,上海200040 [2]复旦大学上海医学院,上海200030 [3]复旦大学附属华东医院消化科,上海200040 [4]国家老年疾病临床医学研究中心,复旦大学附属华山医院,上海200040

出　　处：《老年医学与保健》2019年第4期451-455,459,共6页Geriatrics & Health Care

基　　金：国家重点研发计划（2018YFC2002000）;上海市申康医院发展中心三年行动计划（16CR3055A）;上海市2017年度中央引导地方科技发展专项（YDZX20173100004026）

摘　　要：目的调查65岁及以上老年住院患者的躯体衰弱和认知衰弱情况并分析其影响因素。方法2018年10月—12月以复旦大学附属华东医院老年科65岁及以上住院患者139例为研究对象。采用老年综合评估技术对研究对象进行评估,同时进行躯体衰弱和认知衰弱评估。采用SPSS23.0软件对躯体衰弱和认知衰弱进行单因素和多因素统计学分析。结果躯体衰弱患病率为50.36%,衰弱前期为38.85%,认知衰弱为43.17%。单因素分析结果显示,躯体衰弱组年龄较高、Tinetti评分较低,衰弱组营养不良、嗜睡、功能依赖、认知功能障碍、抑郁、肌少症等占比例较高(P<0.05);有序多分类结果显示,认知功能障碍是躯体衰弱的危险因素(P=0.035),OR值为2.60(1.07,6.43)。二分类Logistic回归分析显示,肌少症是认知衰弱的影响因素(P=0.007),OR值为5.46(1.57,18.35)。结论老年住院患者躯体衰弱和认知衰弱患病率较高,躯体衰弱与认知功能障碍密切相关,认知衰弱与肌少症密切相关,老年科临床医师和护理工作者应对入院患者进行躯体衰弱和认知衰弱评估,并有重点的采取干预措施,提高老年住院患者生活质量。Objective To investigate the physical and cognitive frailty in hospitalized elderly aged ≥ 65 years and over and to explore the influencing factors. Methods 139 elderly aged ≥65 years hospitalized during the period from Oct., 2018 to Dec., 2018 were selected;Comprehensive Geriatric Assessment (CGA) was performed and the physical and cognitive frailty were evaluated;univariate and multivariate analysis were made with software SPSS23.0. Results The morbidity rate of physical frailty, pre-frailty and cognitive frailty was 50.36%, 38.85%and 43.17% respectively;univariate analysis showed that the elderly with physical frailty were of older age and lower Tinetti scores, most of them suffered from poor nutrition, drowsiness, functional dependency, cognitive disorder, depression and sarcopenia (P<0.05);ordered multinomial analysis showed that cognitive frailty was the risk factor of physical frailty [P=0.035, OR: 2.60 (1.07,6.43)];binary Logistic regression analysis indicated that sarcopenia was the influencing factor of cognitive frailty [P=0.007, OR: 5.46 (1.57, 18.35)]. Conclusions The morbidity rate of physical and cognitive frailty is high in hospitalized elderly;physical frailty is closely correlated to cognitive frailty while cognitive frailty is closely correlated to sarcopenia;physical and cognitive frailty assessment should be made to the hospitalized elderly and certain targeted intervention measures should be taken so as to promote their quality of life.

关 键 词：躯体衰弱 认知衰弱 老年 影响因素 

分 类 号：R473[医药卫生—护理学]