我国老年人群衰弱不同测量方法的比较分析——基于江苏省如皋市某镇2021年调查  

Comparison of different frailty measurements among Chinese elderly population based on the 2021 survey in one town of Rugao City,Jiangsu Province

作　　者：杨淦 李小明 曹星琦 孙素丹 李薛琴 吴维诚 孙学会 邵伟 刘成国 贺迪 张静芸 马丽娜[6] 王笑峰 朱益民[5] 刘足云 Yang Gan;Li Xiaoming;Cao Xingqi;Sun Sudan;Li Xueqin;Wu Weicheng;Sun Xuehui;Shao Wei;Liu Chengguo;He Di;Zhang Jingyun;Ma Lina;Wang Xiaofeng;Zhu Yimin;Liu Zuyun(School of Public Health,Second Affiliated Hospital,Zhejiang University School of Medicine,The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province,Zhejiang University School of Medicine,Hangzhou 310058,Zhejiang,China;North China University of Science and Technology,Tangshan 063210,Hebei,China;Human Phenome Institute and School of Life Sciences,Fudan University,Shanghai 200438,China;People's Hospital of Putuo District of Zhoushan City,Zhoushan 316100,Zhejiang,China;School of Public Health and Sir Run Run Shaw Hospital,Zhejiang University of Medicine,Hangzhou 310058,Zhejiang,China;Department of Geriatrics,Xuanwu Hospital Capital Medical University,National Clinical Research Center for Geriatric Diseases,Beijing 100053,China)

机构地区：[1]浙江大学医学院附属第二医院,浙江大学医学院,公共卫生学院浙江省智能预防医学重点实验室,浙江杭州310058 [2]华北理工大学公共卫生学院,河北省煤矿卫生与安全实验室,河北唐山063210 [3]复旦大学人类表型组研究院,复旦大学生命科学学院,上海200438 [4]舟山市普陀区人民医院内分泌科,浙江舟山316100 [5]浙江大学医学院公共卫生学院,浙江大学医学院附属邵逸夫医院,浙江杭州310058 [6]首都医科大学宣武医院老年医学科,国家老年疾病临床研究中心,北京100053

出　　处：《中国医学前沿杂志（电子版）》2023年第10期49-60,I0001,共13页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：浙江省“尖兵”“领雁”研发攻关计划项目(2023C03163);温州市高水平建设老年友好型城市研究课题(23PGZX0602);上海市市级重大专项“国际人类表型组计划”(2017SHZDZX01);中央高校基本科研业务费;浙江省智能预防医学重点实验室(2020E10004)。

摘　　要：目的分析比较老年人群中6种常见衰弱测量方法之间的联系和区别。方法以2021年江苏省如皋市某镇866例老年人为研究对象,采用Fried表型衰弱量表(Fried Frailty Phenotype,FFP)、衰弱筛查问卷(Frailty Screening Questionnaire,FSQ)、衰弱表型问卷(Frailty Phenotype Questionnaire,FPQ)、FRAIL量表(FRAIL scale)和骨质疏松骨折研究(Study of Osteoporotic Fractures,SOF)指数测量研究对象衰弱状态。此外,本研究在FSQ的四项自报告问题基础上加上一项自报告体重下降,构成FSQV2(模拟FFP)。计算Kappa系数比较各测量方法之间的一致性,并通过Logistic回归模型分析衰弱状态与研究对象患共病之间的关联。基于浙江省舟山市某地区2020年的调研数据,重复以上比较分析。结果在866例平均年龄为(80.6±4.4)岁研究对象中,男性占47.3%;患共病的研究对象占33.5%。衰弱状态按照健壮、衰弱前期和衰弱三分类,FRAIL与FFP、FSQ、FSQV2、FPQ的Kappa系数分别为0.53、0.63、0.70、0.93;FSQ与FFP、FSQV2和FPQ的Kappa系数分别为0.56、0.88、0.66。衰弱状态按照非衰弱、衰弱二分类,FRAIL与FFP、FSQ、FSQV2、FPQ均具有中等程度及非常好的一致性;FSQ与FFP、FSQV2和FPQ具有中等程度及以上的一致性。Logistic回归模型分析结果显示,6种衰弱测量方法均与患共病显著相关;其中效应最大的是FRAIL与患共病的关联(OR=4.38,95%CI:2.68~7.16);其次为FSQ和FSQV2(OR=2.98,95%CI:1.77~5.00和OR=2.96,95%CI:1.83~4.80)。基于浙江省舟山市某地区的数据分析,我们得到较为类似的结果,但未发现衰弱与患共病的关联。结论6种衰弱测量方法测量江苏省如皋市老年人衰弱状态存在差异,FRAIL、FSQ和FSQV2与其他衰弱测量方法均具有较好的一致性,且与患共病显著相关;这3种测量方法可能适用于我国老年人衰弱状态的筛查。Objective To analyze and compare the the relationship and difference between performance of six frailty measurements in the elderly population in Rugao city,Jiangsu province.Methods A total of 866 older participants were randomly selected in one town of Rugao City,Jiangsu Province.Frailty was measured using Fried Frailty phenotype(FFP),Frailty Screening Questionnaire(FSQ),Frailty Phenotype Questionnaire(FPQ),FRAIL Scale(FRAIL),and the Study of Osteoporotic Fractures(SOF).Additionally,FSQV2 was constructed based on the four self-reported items of FSQ and one self-reported item,weight loss.Cohen's kappa coefficient was applied to compare the consistency among the frailty measurements.Logistic regression model was used to analyze the association between frailty measurements and comorbidity.Results The average age of the 866 participants was(80.6?.4)years,and the proportion of men was 47.3%.Comorbidity accounted for 33.5%of the study subjects.When frailty was classified into robust,pre-frailty,and frailty,the Kappa coefficients of FRAIL scale with FFP,FSQ,FSQV2,and FPQ,were 0.53,0.63,0.70 and 0.93,respectively.The Kappa coefficients of FSQ with FFP,FSQV2,and FPQ were 0.56,0.88 and 0.66.When frailty was classified into robust and frailty,the consistency of FRAIL scale with FFP,FSQ,FSQV2,and FPQ ranged from moderate to excellent.The consistency of FSQ with FFP,FSQV2,and FPQ was moderate to excellent.Logistic regression model analysis showed that all six frailty measurements were significantly associated with comorbidity.The largest odds ratio(OR)was for FRAIL scale(OR=4.38,95%CI:2.68-7.16),FSQ(OR=2.98,95%CI:1.77-5.00),and FSQV2(OR=2.96,95%CI:1.83-4.80).Conclusions The six frailty measurements differed in measuring the frailty status of older adults in Rugao city.FRAIL scale,FSQ and FSQV2 had good consistency with other frailty measurements,and were significantly associated with comorbidity.The findings suggest that FRAIL scale,FSQ,and FSQV2 could be used to screen frailty in the older Chinese adults in the community.

关 键 词：衰弱测量 共病 一致性 老年人群 

分 类 号：R161.7[医药卫生—公共卫生与预防医学]