FRAIL量表和Tilburg量表在社区老年糖尿病患者衰弱评估中的应用比较

目的比较衰FRAIL量表和Tilburg衰弱量表(TFI)在社区老年糖尿病人群中的诊断能力及预测能力。方法便利抽样法选取衡阳市4个社区的343名年龄≥60岁的糖尿病患者为研究对象,采用一般情况调查表、衰弱表型、FRAIL量表、TFI量表进行资料收集。结果当处于原始临界值时,衰弱表型、FRAIL量表、TFI量评估的衰弱比例分别为26.53%(91/343)、25.07%(86/343)、57.73%(198/343);以衰弱表型为参考标准,FRAIL量表和TFI量表的ROC曲线下面积分别为0.962和0.890,两者的面积之差为0.072(Z=3.357,P<0.01),FRAIL量表和TFI量表的最佳临界值分别为2.5和5.5;以跌倒和住院为预测指标,3种衰弱评估工具对跌倒和住院的预测能力均较低(0.656~0.687),且三者的ROC曲线下面积差异无统计学意义(Z=0.695,P>0.05)。结论在社区老年糖尿病患者中,FRAIL量表的诊断性能优于TFI量表,但3种衰弱评估工具对社区老年糖尿病患者跌倒和住院的预测能力均较低。

Comparison of FRAIL Scale and Tilburg Frailty Indicator Scale in assessment of frailty status of elderly patients with diabetes in the community

Objective To compare the diagnostic ability and predictive power of the FRAIL Scale and Tilburg Frailty Indicator Scale(TFI)in assessment of frailty status of elderly patients with diabetes in the community.Methods A total of 343 diabetic patients aged 60 years or older in 4 communities in Hengyang City were selected by the convenience sampling method.The general questionnaire,Frailty Phenotype,FRAIL scale and TFI scale were used for data collection.Results When at the original critical value,The prevalence of frailty by using Frailty Phenotype,FRAIL scale,and TFI Scale was 26.53%(91/343),25.07%(86/343),57.73%(198/343),respectively.Taking Frailty Phenotype as the reference,the areas under the ROC curve of the FRAIL scale and the TFI scale were 0.962 and 0.890,respectively,and the difference between the two areas was 0.072(Z=3.357,P<0.01).The optimal cut off points for FRAIL scale and TFI scale were 2.5 and 5.5.Taking fall events and hospitalization as predictors,the areas under the ROC curve of the frailty assessment tool to predict falls and hospitalization was low(0.656-0.687),and there was no significant difference in the area under the ROC curve of the three scales(Z=0.695,P>0.05).Conclusion The diagnostic performance of the FRAIL scale is superior to the TFI scale in elderly patients with diabetes in the community,but the three frailty assessment tools have lower predictive power for falls and hospitalization in elderly patients with diabetes in the community.