老年神经病患者虚弱状况调查及影响因素分析

Status and influencing factors of frailty in geriatric neuropathic patients

目的探讨老年神经病患者虚弱状况及影响因素。方法分别采用采用Fried虚弱表型测评量表、工具性日常生活活动能力量表(IADL)及荣格抑郁自评量表(SDS)评价254例老年神经病患者的虚弱情况、日常生活活动能力及情绪状态。分析老年神经病患者虚弱的影响因素。结果 Fried虚弱表型测评量表显示,虚弱41例(16.14%),虚弱前期155例(61.02%),无虚弱58例(22.83%);体力活动减少106例(41.73%)、自评疲劳感103例(40.55%)、行走速度减慢86例(33.86%)、握力降低81例(31.89%)、体质量下降69例(27.17%)。65~74岁患者无虚弱比率显著高于,虚弱前期及虚弱比率显著低于75~84岁及≥85岁的患者(P<0.05~0.01);≥85岁的患者虚弱比率显著高于75~84岁的患者(P<0.01)。与无虚弱组比较,虚弱前期组及虚弱组冠心病及缺血性脑血管病比率显著升高(均P<0.05)。与虚弱前期组比较,虚弱组糖尿病、冠心病及缺血性脑血管病比率显著升高(均P<0.05)。单因素分析显示,年龄、共病、日常生活活动能力差及抑郁是老年神经病患者虚弱的相关因素(均P<0.01)。多因素Logistic回归分析显示,年龄≥75岁、共病≥3种、IADL>5分、SDS>50分是老年神经病患者虚弱发生的独立危险因素(P<0.05~0.01)。结论随着年龄的增长,虚弱患者比率逐渐增高。且虚弱患者以疲劳感、体力活动减少为著,患冠心病、缺血性脑血管病比率高。高龄、共病≥3种、日常生活活动能力差及抑郁是老年神经病患者虚弱发生的独立危险因素。

Objective To investigate the status and influencing factors of frailty in geriatric neuropathic patients. Methods Use Fried frailty phenotype scale, instrumental activities of daily living （IADL） and Zung self-rating depression scale （SDS） to evaluate the frailty, daily living and emotional state in 254 geriatric neuropathie patients and analysis the factors of frailty. Results Fried frailty phenotype scale showed 41 of frailty （ 16.14% ） , 155 of pre-fraihy （61. 02% ） and 58 non-frailty （22. 83% ）. It also showed 106 of reduced physical activity （41.73%）, 103 of self-evaluate of fatigue （40.55%）, 86 of slow walking speed （33.86%）, 81 of gripping force （31.89% ） and 69 of weight loss （27.17%）. The rate of non-frailty in 65 -74 years old patients was significantly increased, the rates of pre-frailty and frailty were significantly decreased than those in 75 - 84 years old and ≥ 85 years old patients （P 〈 0. 05 -0.01 ）. The rate of frailty in ≥85 years old patients was significantly increased than that in 75-84 years old patients （P〈 0. 01 ）. Compared with non-frailty group, the incidence of coronary heart disease and isehemic eerebrovaseular disease of pre-frailty group and frailty group were significantly increased （all P 〈0. 05 ）. Compared with pre-frailty group, the incidence of diabetes, coronary heart disease and ischemic cerebrovascular disease of frailty group were significantly increased （ all P 〈 0. 05 ）. Single factor analysis showed that age, multi-disease, poor of daily living and depression were related factors of frailty （all P〈 0.01 ）. Logistic regression analysis showed that ≥ 75 years old, multi-disease ≥ 3, IADL 〉 5 points, SDS 〉 50 points were independent risk factors of frailty （P 〈 0. 05 -0.01 ）. Conclusions As age increases, the rate of frailty patients is increasing. The weakness of fatigue and physical activity is most evident in frailty patients and has high ratio of coronary heart disease and ischemic cerebrovascular disease. Advanced age, multl-disease, poor of daily living and depression are independent risk factors of frailty.