老年人虚弱的测评和干预研究进展

  目的  了解高龄老年人衰弱程度，分析亲子关系对衰弱的影响。  方法  于2016年7月 — 2017年1月采用分层随机整群抽样方法，选取河北省唐山市10个社区卫生服务中心辖区居民中的≥ 75岁高领老年人，进行衰弱综合评估工具（CFAI）评测。  结果  3 448名高龄老年人均有衰弱，其中轻度衰弱1 093人（31.70 %），中度衰弱1 230人（35.67 %），重度衰弱1 125人（32.63 %）；多元回归分析显示，女性（OR = 1.220）、年龄≥ 80岁（OR = 2.030）、有同城居住的子女（OR = 2.376、）、与子女关系不和睦（OR = 6.314）、子女不轮流看望（OR = 1.309）、不经常与子女交流（OR = 1.869）、不经常与子女打电话（OR = 1.366）是高龄老年人衰弱程度的危险因素（P < 0.05）。文化程度高中及以上（OR = 0.607）、子女经常采取老人意见（OR = 0.506）是高龄老人衰弱程度的保护因素（P < 0.05）。  结论  不良亲子关系可加速中高龄老年人衰弱进程，子女应注重加强与老年人之间的沟通，增进与老年人的感情，延缓衰弱进程，实现健康老龄化。

The comprehensive frailty assessment instrument: development,validity and reliability

  Objective  To examine the status of frailty and to explore impacts of parent-child relationship on frailty among oldest-old people.  Methods  We recruited 3 448 oldest-old residents aged ≥ 75 years with stratified random cluster sampling from communities covered by 10 community health care centers in Tangshan city of Hebei province and then conducted a household survey among the participants between July 2016 and January 2017 with a self-designed general questionnaire and Comprehensive Frailty Assessment Instrument (CFAI).  Results  Among all the participants, the prevalence rate of frailty was 100 %, with 1 093 (31.70%), 1 230 (35.67 %), and 1 125 (32.63 %) participants having mild, moderate, and severe frailty, respectively. Multivariate regression analyses revealed that among the participants, significant risk factors of frailty included female gender (odds ratio [OR]=1.220, 95% confidence interval [95 % CI]: 1.020 – 1.461), aged 80 years and older (OR = 2.030, 95 % CI: 1.596 – 2.581), with children living in a same city as the parents' home town (OR = 2.376, 95 % CI: 1.257 – 4.490), having inharmonious relationship with children (OR = 6.314, 95 % CI: 4.561 – 8.741), without alternate visits of children (OR = 1.309, 95 % CI: 1.078 – 1.589), not communicating with children frequently (OR = 1.869, 95% CI: 1.103 – 3.168), and having no frequent telephone calls with children (OR = 1.366, 95 % CI: 1.106 – 1.686) (all P < 0.05); whereas, the protective factors against frailty were the education of senior high school and above (OR = 0.607, 95 % CI: 0.375 – 0.980) and frequent acceptance of participants' advise by their children (OR = 0.506, 95 % CI: 0.374 – 0.685) (both P < 0.05).  Conclusion  Poor parent-child relationship could aggravate frailty condition of middle-old and oldest-old persons and communication between oldest-old people and their children should be promoted for the implementation of healthy aging.