FRAIL-NH量表和Tilburg衰弱量表对养老机构老年人衰弱评估比较

Comparison of frail status with FRAIL-NH Scale and Tilburg Frailty Indicator among institutional older adults

目的:比较FRAIL-NH量表与Tilburg衰弱量表(Tilburg Frailty Indicator,TFI)对养老机构老年人衰弱的评估能力及评估效果,为养老机构衰弱方面的实践和研究提供指导。方法:采用便利抽样法选取长沙市6所养老机构的302名老年人为研究对象,采用一般资料调查问卷、衰弱指数(FrailtyIndex,FI)、FRAILNH量表以及TFI进行资料收集。结果:以FI判断的衰弱状态为参照,FRAIL-NH、TFI的ROC曲线下面积分别为0.861,0.776,两者ROC曲线下面积之差为0.085(Z=3.455,P<0.001);FRAIL-NH和TFI的衰弱临界值分别为1.5和4.5;二者与FI在衰弱判定方面的交叉验证准确率分别为70.9%,71.9%。FI、FRAIL-NH、TFI三者评估的衰弱发生率分别为66.6%、69.5%、68.5%。结论:相比TFI,FRAIL-NH更适用于养老机构老年人衰弱评估。

Objective: To compare the ability and efficacy of FRAIL-NH Scale and Tilburg Frailty Indicator (TFI) in assessment of frailty in institutional older adults so as to provide guidance for the practice and research on frailty in pension institutions. Methods: A total of 302 older adults in six pension institutions from Changsha were recruited by convenience sampling. Frailty was assessed by the Frailty Index (FI), FRAIL-NH Scale and TFI. General information was collected by a self-designed general information questionnaire. Results: Taking FI as the reference, the areas under the ROC curve for FRAIL-NH and TFI were 0.861 and 0.776 respectively, the difference of area under ROC curve between FRAIL-NH and TFI was 0.085 (Z=3.455, P<0.001). The cut off points for FRAIL-NH and TFI in classifying non-frailty and frailty were 1.5 and 4.5, respectively. The cross-validation accuracy of them were 70.9% and 71.9%, respectively. The prevalence of frailty was 66.6%, 69.5% and 68.5% by the assessment of FI, FRAIL-NH and TFI, respectively. Conclusion: Compared with TFI, FRAIL-NH is more appropriate for the frailty assessment among institutional older adults.