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老年心血管疾病与衰弱的关系

Relationship between cardiovascular disease and frailty of elderly people
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摘要 目的探究社区老年心血管疾病(cardiovascular disease,CVD)与衰弱前期及衰弱的关系。方法纳入2020年10月至2021年10月居住在鄂尔多斯市伊金霍洛旗社区的3080名老年居民(年龄≥65岁)进行横断面调查研究,对入选者的年龄、性别、健康状况、疾病数量、CVD(冠心病、脑卒中、心肌梗死、心力衰竭)的患病情况及衰弱筛查量表[包括疲劳感(fatigue)、阻力感(resistance)、自由活动力下降(ambulation)、多种疾病共存(illness)、体质量减轻(loss of weight),简称FRAIL量表]的内容进行问卷调查,根据纳入与排除标准最终选取符合条件的2353名老年居民作为研究对象,其中无衰弱者776名,衰弱前期者1100例,衰弱者477例。根据问卷调查结果将入选者分为CVD组和无CVD组,分析入选者的一般资料及老年人CVD的患病情况与衰弱前期及衰弱的关系。结果单因素分析表明,性别、年龄、疾病数量、健康状况及心血管疾病患病情况与老年人衰弱前期或衰弱呈正相关(P<0.05)。多元logistic回归分析表明,与无CVD组相比,CVD组中发生衰弱前期(O R=12.222,95%C I:8.399~17.783,P<0.05)或衰弱比例更高(O R=16.217,95%C I:10.891~24.147,P<0.05)。多元多因素logistic回归分析结果表明,与无CVD组相比,冠心病(O R=5.873,95%C I:3.437~10.036,P<0.05)、脑卒中(O R=5.117,95%C I:3.071~8.524,P<0.05)、心肌梗死者(O R=10.977,95%C I:1.443~83.486,P<0.05)衰弱前期的患病率更高。与无CVD组相比,有冠心病(O R=5.996,95%C I:3.414~10.530,P<0.05)、脑卒中者(O R=4.384,95%C I:2.534~7.583,P<0.05)衰弱的患病率更高。结论老年CVD患者衰弱前期及衰弱的患病率高于无CVD者,应积极筛查老年CVD患者的衰弱情况,为CVD合并衰弱前期或衰弱者制定个体化诊疗方案,以期改善预后。 Objective This study aims to explore the relationship between cardiovascular diseases(CVD)and the stages of frailty,including pre-frailty and frailty,among the elderly in communities.Methods A cross-sectional survey was conducted,including 3080 elderly residents(aged≥65 years)living in the Yijinhuo Luoqi community in ordos City from October 2020 to October 2021.Participants were surveyed on their age,gender,health status,number of illnesses,instances of CVD(coronary heart disease,stroke,myocardial infarction,and heart failure),and assessed using the Frailty criteria.Based on inclusion and exclusion criteria,2353 eligible elderly residents were selected,comprising 776 non-frail,1100 pre-frail,and 477 frail individuals.Participants were categorized into groups with and without CVD based on survey results.The baseline clinical data and the relationship between the prevalence of CVD and the stages of frailty among the elderly were analyzed.Results A total of 2353 elderly residents were enrolled.Univariate analysis indicated significant correlations between sex,age,number of diseases,health status,and prevalence of cardiovascular diseases with both pre-frailty and frailty in the elderly(P<0.05).Multivariate logistic regression analysis revealed that the odds of pre-frailty(O R=12.222,95%CI:8.399—17.783,P<0.05)and frailty(O R=16.217,95%CI:10.891—24.147,P<0.05)were higher in CVD patients compared to those without CVD.Further multivariate and multifactorial logistic regression analysis showed that the prevalence of pre-frailty was significantly higher in patients with coronary heart disease(O R=5.873,95%CI:3.437—10.036,P<0.05),stroke(O R=5.117,95%CI:3.071—8.524,P<0.05),and myocardial infarction(O R=10.977,95%CI:1.443—83.486,P<0.05)compared to those without CVD.Similarly,a higher frailty rate was observed in patients with coronary heart disease(O R=5.996,95%CI:3.414—10.530,P<0.05)and stroke(O R=4.384,95%CI:2.534—7.583,P<0.05)compared to non-CVD individuals.Conclusions The prevalence of prefrailty and frailty in elderly CVD patients is significantly higher than in those without CVD.It is crucial to proactively screen for frailty in elderly CVD patients and develop personalized diagnostic and treatment plans for those with pre-frailty or frailty to improve their prognosis.
作者 刘晓杰 刘振兵 LIU Xiao-jie;LIU Zhen-bing(Baotou Medical College,Inner Mongolia University of Science&Technology,Baotou,Inner Mongolia 014000,China;不详)
出处 《慢性病学杂志》 2024年第5期647-652,658,共7页 Chronic Pathematology Journal
基金 国家重点研发计划——老年衰弱快速筛查评估量表的研发与建立(2018YFC2002001)
关键词 心血管疾病 衰弱前期 衰弱 老年 关系 Cardiovascular diseases Pre-frailty Frailty Elderly Relationship
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