摘要目的:观察临床衰弱量表(CFS)与Fried衰弱表型量表(FFP)、Edmonton衰弱量表(EFS)在养老机构人群中评估衰弱的表现。方法:2021年10—12月采用方便抽样方法选取北京地区4所养老机构60岁及以上老年人167例为研究对象。采用CFS、FFP、EFS进行衰弱评估，比较评估结果的一致性和差异性，分析各量表评分与健康指标的相关性，并通过受试者工作特征曲线(ROC)比较3种量表识别失能的能力。结果:CFS的衰弱检出率最高为35.33%(59/167)，高于FFP的23.35%(39/167)( χ2＝9.500、 P＝0.002)和EFS的24.55%(41/167)( χ2＝7.605、 P＝0.005)，CFS与FFP、CFS与EFS、FFP与EFS的结果一致性检验Kappa值分别为0.461、0.465、0.441(均 P<0.001)。校正年龄和性别后，仅CFS评分与慢病数量呈正相关( r＝0.190、 P＝0.018)；CFS、FFP、EFS评分均与握力、简易躯体功能评估(SPPB)、简易精神状态量表(MMSE)呈负相关(均 P<0.05)，与老年人抑郁量表(GDS-15)呈正相关(均 P<0.05)，且EFS评分与握力的相关系数低于CFS、FFP评分(－0.248比－0.431， P＝0.009；－0.248比－0.536， P<0.001)；CFS、FFP评分与PhA呈负相关( r＝－0.189、－0.243， P＝0.016、0.002)。ROC分析结果显示，CFS、FFP和EFS评分识别失能的ROC曲线下面积(AUC)分别为0.87、0.78、0.76(均 P<0.001)，CFS高于FFP( Z＝2.175、 P＝0.030)和EFP( Z＝2.585、 P＝0.010)。 结论:在养老机构人群中CFS具有较好的衰弱检出率和失能识别能力，有助于衰弱老年人的及时干预和养老机构的医疗照护决策。

abstractsObjective:To evaluate the effectiveness of the clinical frailty scale(CFS), the fried frailty phenotype scale(FFP), and the Edmonton frailty scale(EFS)in assessing frailty among elderly individuals residing in nursing homes.Methods:Convenience sampling methods were used to enroll 167 elderly individuals aged 60 years and above from four Beijing nursing homes for this study conducted from October to December 2021.The CFS, FFP, and EFS were used for assessing frailty.The consistency and discrepancies of the assessment results were analyzed.Furthermore, the correlation between the scores of each scale and the health indicators was examined.The effectiveness of the three scales in identifying disability was evaluated using the receiver operating characteristic curve(ROC).Results:The study found that the highest detection rate of frailty was 35.33%(59/167)for CFS, which was higher than the rates for FFP(23.35%, 39/167)and EFS(24.55%, 41/167).The statistical analysis showed significant differences between the groups( χ2=9.500, P=0.002 for CFS vs.FFP; χ2=7.605, P=0.005 for CFS vs.EFS).The Kappa values for the consistency of results between CFS and FFP, CFS and EFS, and FFP and EFS were 0.461, 0.465 and 0.441, respectively(all P<0.001).After adjusting for age and gender, only the CFS score showed a positive correlation with the number of chronic diseases( r=0.190, P=0.018).The CFS, FFP, and EFS scores were negatively correlated with grip strength, short physical performance battery(SPPB), and mini-mental state examination(MMSE)(all P<0.05), and positively correlated with the 15-item geriatric depression scale(GDS-15)( P<0.05).The correlation coefficients between CFS and FFP scores and grip strength were higher than that of EFS(-0.431 vs.-0.248, P=0.009; -0.536 vs.-0.248, P<0.001).Additionally, the CFS and FFP scores were negatively correlated with phase angle(PhA)( r=-0.189, P=0.016; r=-0.243, P=0.002).The analysis of the ROC revealed that the area under the ROC curve(AUC)for CFS, FFP and EFS in identifying disability were 0.87, 0.78 and 0.76 respectively(all P<0.001).The AUC value of CFS was found to be higher than that of FFP( Z=2.175, P=0.030)and EFP( Z=2.585, P=0.010). Conclusions:The CFS has been found to have a higher detection rate of frailty and a better ability to identify disability among the elderly residing in nursing homes.This improved detection and identification can facilitate timely interventions for frail individuals and aid in making informed healthcare decisions within nursing home settings.