摘要目的 探讨社区老年人衰弱状态的过渡情况,以及衰弱状态恶化的影响因素.方法 在四川省都江堰市平义社区建立≥65岁老年人队列,分别于2014年1月和2017年1月进行面对面问卷调查,内容包括衰弱状态、认知功能、营养状况和功能状态等.采用二元logistic回归分析衰弱状态恶化的影响因素.结果 2014年1月调查了653名老年人,2017年1月进行随访,146名失访,共对507名老年人进行分析.基线调查时衰弱和衰弱前期的患病率分别为11.2％(57人)和26.2％(133人).3年后,205名(40.4％)老年人衰弱状态恶化,276名(54.5％)老年人保持不变,26名(5.1％)老年人衰弱状态改善.在校正基线衰弱状态后,失能(OR=8.27,95％CI:1.62 ～ 42.26)、视力障碍(OR=2.02,95％CI:1.27～3.22)、认知功能障碍(OR=1.94,95％CI:1.08 ～ 3.48)、自评健康状态差(OR=1.89,95％CI:1.07～3.31)、慢性疼痛(OR=1.57,95％CI:1.03 ～ 2.40)和年龄(OR=1.12,95％CI:1.08～1.17)是衰弱状态恶化的危险因素;而超重是衰弱状态恶化的保护因素(OR=0.54,95％CI:0.34 ～ 0.85).结论 衰弱是一种动态综合征,失能、视力障碍、认知功能障碍、自评健康状态差、慢性疼痛和年龄是衰弱状态恶化的独立危险因素,而超重是其保护因素.

abstractsObjective To investigate frailty progress status and related factors in the elderly living in communities.Methods A cohort of elderly people aged 65 and over in Pingyi community of Dujiangyan,Sichuan province,was established.Face-to-face questionnaire survey was conducted by trained interviewers.The frailty status,cognitive function,nutrition status and other functions of the subjects surveyed were evaluated at baseline survey and during follow-up.The socio-demographic and clinical characteristics of the subjects surveyed were assessed at baseline survey.Binary logistic regressions were used to identify factors associated with frailty progress.Results A total of 653 elderly people were surveyed in January 2014,and 507 elderly people were followed up while 146 elderly people terminated further follow-up in January 2017.The prevalence rates of frailty and pre-frailty at baseline survey were 11.2％ (n=57) and 26.2％ (n=133),respectively.After 3 years,205 subjects (40.4％) surveyed experienced frailty progress,276 (54.5％) remained to be in frailty state at baseline survey,and 26 (5.1％) had improvement.Disability (OR=8.27,95％CI:1.62-42.26),visual problem (OR=2.02,95％CI:1.27-3.22),cognitive impairment (OR=1.94,95％CI:1.08-3.48),poor self-rated health (OR=1.89,95％ CI:1.07-3.31),chronic pain (OR=1.57,95％ CI:1.03-2.40) and older age (OR =1.12,95％CI:1.08-1.17) were independently associated with the progress of frailty.In contract,overweight was a protective factor (OR=0.54,95％CI:0.34-0.85).Conclusions Frailty is a dynamic syndrome affected by several socio-demographic factors and geriatric factors.The results of the study can be used in the prevention of frailty progress in the elderly in communities.