社区老年人衰弱评估方法的研究进展

Evaluation Methods of Frailty in the Community-dwelling Elderly

衰弱是老年人常见的临床综合征。全科医生作为民众健康的守门人,在社区老年人衰弱的识别中发挥着重要作用。目前国际上开发了多种衰弱评估方法,但我国在此方面的研究仍处于起步阶段。本文就衰弱评估方法的内容、优缺点,以及在我国社区老年人中调适、应用情况进行综述,旨在为全科医生后期开展老年人群衰弱评估及相关研究提供参考。通过本综述,得出以下主要结论:衰弱的评估方法分为筛查方法和综合评估方法,建议将衰弱表型定义(FFP)、蒂尔堡衰弱指标(TFI)、格罗宁根衰弱指标(GFI)、衰弱量表(FRAIL)、衰弱综合评估工具(CFAI)、步速、握力和起立-行走试验(TUGT)作为社区门诊衰弱筛查方法,将埃德蒙顿衰弱量表(EFS)和衰弱指数(FI)用于综合评估。各评估方法在不同人群中的适用性和有效性,仍需未来进一步研究验证。

Frailty is a common clinical syndrome in the elderly.General practitioners,the gatekeepers for people’s health,play an important role in the identification of frailty in the elderly.A large number of evaluation methods of frailty have been developed in foreign countries,but the research in this field is still in the early stage in China.To provide help for domestic general practitioners to evaluate frailty in elderly people and conduct related studies,we reviewed the evaluation methods of frailty with a concise description of their contents,strengths and limitations,as well as the application of their Chinese versions in evaluating frailty in community-dwelling Chinese older adults,and summarized the key points as follows:these methods may be classified into frailty screening methods and comprehensive evaluation methods.The Fried Frailty Phenotype,Tilburg Frailty Indicator,Groningen Frailty Indicator,the Frail Scale,Comprehensive Frailty Assessment Instrument,walking speed,grip strength and Timed Up-and-Go test are suggested to be used as screening methods of frailty in community outpatients,and Edmonton Frailty Scale and Frailty Index can be used for comprehensive evaluation.The applicability and effectiveness of the evaluation methods in different populations need to be verified in further research.