南京市养老机构老年人衰弱现状及危险因素分析

Frailty among institutionalized elderly people in Nanjing city: prevalence and risk factors

目的了解江苏省南京市养老机构老年人衰弱现状及其危险因素,为老年人的健康干预提供参考依据。方法于2015年7月采用整群抽样和目的抽样相结合的方法对在南京市14家养老机构抽取的479名老年人进行问卷调查。结果南京市479名养老机构老年人检出衰弱者147例,衰弱检出率为30.7%;其中,不明原因体重下降、自感疲乏、握力下降、行走速度减慢和身体活动量低的检出率分别为7.1%、15.7%、79.7%、72.9%和24.2%;多因素非条件logistic回归分析结果显示,自评健康状况一般(OR=1.918,95%CI=1.152~3.193)和差(OR=3.021,95%CI=1.561~5.846)、日常生活活动能力轻度受损(OR=2.433,95%CI=1.301~4.550)和中重度受损(OR=6.051,95%CI=1.401~30.171)、社会参与能力中重度受损(OR=2.596,95%CI=1.525~4.419)是南京市养老机构老年人衰弱发生的危险因素。结论南京市养老机构老年人衰弱状况较重,自评健康状况较差、日常生活活动能力受损和社会参与能力受损的老年人更易发生衰弱。

Objective To estimate the prevalence of frailty and to explore risk factors of frailty among elderly people in endowment institutions in Nanjing city for providing evidences for establishing intervention programs.Methods A cross-sectional study was conducted among 479 persons aged 60 years and older selected with cluster sampling combined with purposive sampling in 14 endowment institutions in Nanjing city during July 2015. The influence factors of frailty were analyzed with binary logistic regression model.Results Among the participants, 147 were identified with frailty and the prevalence of frailty were 30.7%; the proportions of main frailty problems were 79.7% for grip weakness, 72.9% for slow walking speed, 24.2% for low physical activity level, 15.7% for perceived fatigue, and 7.1% for reduction in body weight, respectively. The results of multivariate logistic regression analyses showed that the risk factors for frailty among the participants were with a general self-rated health status （odds ratio[OR]=1.918, 95% confidence interval[95% CI]：1.152-3.193） and a poor self-rated health （OR=3.021, 95% CI：1.561-5.846）, with a slightly impaired activity of daily life （OR=2.433, 95% CI：1.301-4.550）, with a moderately or severely impaired activity of daily life （OR=6.051, 95% CI：1.401-30.171）, and with a severely impaired social participation （OR=2.596, 95% CI：1.525-4.419）.Conclusion The prevalence of frailty is high and associated mainly with poor self-rated health and impaired activity of daily life and social participation among the elderly people living in endowment institutions in Nanjing city.