老年住院患者社会衰弱与生理衰弱的相关性

Correlation between social frailty and physical frailty of elderly inpatients

摘要:

目的 采用横断面研究分析≥60岁住院患者的社会衰弱情况,并探讨其与躯体功能的关系。 方法 选取首都医科大学宣武医院老年医学综合科≥60岁的住院患者258例,应用社会衰弱量表(HALFT)评估社会衰弱情况,将评分≥3分患者纳入社会衰弱组,其中1~2分患者纳入社会衰弱前期组,0分患者纳入无社会衰弱组,分析社会衰弱的患病情况及影响因素。采用SPSS 20.0软件进行数据分析。根据数据类型,组间比较分别采用t检验、单因素方差分析、χ²检验或Fisher精确概率法。结果 符合社会衰弱组患者31例；非社会衰弱组患者227例,其中社会衰弱前期组患者157例,无社会衰弱组患者70例。与非社会衰弱组相比,社会衰弱组患者年龄较大(P=0.002),更易合并脑血管病(P=0.016),多重用药比例较高(P=0.029),生理衰弱发生率较高(P＜0.001)。进一步行logistic回归分析结果显示生理衰弱是影响社会衰弱的独立危险因素(OR=0.191,95%CI 0.078~0.468,P＜0.001)。相关性分析结果显示,调整性别、年龄之后,HALFT量表评分越高,患者步速越慢(r=-0.325,P<0.001)、握力越差(r=-0.151,P=0.018)、中国老年人闲暇时间体力活动问卷(BLSA-PAQ)评分越低(r=-0.322,P=0.001)、Fried衰弱表型总分越高(r=0.329,P<0.001)。结论 老年住院患者中社会衰弱的患病率较高,生理衰弱是老年人发生社会衰弱的独立危险因素,躯体功能与社会衰弱相关。

Abstract:

Objective To analyze the social frailty of inpatients aged 60 years or over with a cross-sectional study, and to explore its relationship with physical function. Methods A total of 258 inpatients aged ≥60 years admitted in our hospital from January to December 2019 were enrolled in this study. Their social frailty was evaluated by Help, Participation, Loneliness, Financial and Talk (HALFT) scale, and those who scored ≥3 were included in the social frailty group, scored 1-2 in the pre-social frailty group, and scored 0 in the non-social frailty group. The prevalence and influencing factors of social frailty were analyzed. SPSS statistics 22.0 was used to perform the statistical analysis. Student′s t test, one-way analysis of variance, Chi-square test, or Fisher exact test was employed in intergroup comparison for different data types. Results There were 31 patients being assigned into the social frailty group, 157 into the pre-social frailty group, and 70 into the non-social frailty group. Compared with the non-social frailty group, the social frailty group were older (P=0.002), more prone to cerebrovascular disease (P=0.016), and had a higher ratio of multiple medications (P=0.029) and a higher incidence of physical frailty (P<0.001). Logistic regression analysis showed that physical frailty was an independent risk factor for social frailty (OR=0.191,95% CI 0.078-0.468, P<0.001). Correlation analysis results indicated that after adjustment for gender and age, the higher HALFT scale score was, the slower walking speed (r=-0.325, P<0.001), the worse handgrip strength (r=-0.151, P=0.018), the lower score of Beijing Longitudinal Study of Aging Physical Activity Questionnaire (BLSA-PAQ, r=-0.322, P=0.001), and the higher score of Fried phenotype frailty scale (r=0.329, P<0.001). Conclusion The prevalence of social frailty is relatively high for the elderly hospitalized patients. Physical frailty is an independent risk factor for social frailty in them, and physical function is associated with social frailty.