社区老年人心血管疾病危险因素与衰弱关系的研究

Associations between risk factors for cardiovascular diseases and frailty among community-dwelling older adults in Lanzhou,China

目的探讨中国社区老年人心血管疾病危险因素和衰弱的关系。方法采用便利抽样法,调查甘肃省兰州市458名65岁及以上的社区老年人。评估其心血管疾病危险因素及衰弱现状,并探讨两者的关系。应用衰弱表型(不明原因体重下降、疲乏、低体力活动、行走速度下降、握力下降)评价老年人的衰弱状况。心血管疾病危险因素包括血压、身体质量指数(body mass index,BMI)、腰围、血糖、总胆固醇、三酰甘油、低密度脂蛋白和高密度脂蛋白。结果调整了年龄、性別等混杂因素后,与体重正常的老年人(BMI 18.5~23.99 kg/m^(2))相比,肥胖老年人(BMI≥28 kg/m^(2))进入衰弱前期的风险增高(OR=2.26,95%CI:1.05~4.84,P<0.001)。高血压较血压正常的老年人更少发生衰弱(OR=0.31,95%CI:0.11~0.87,P<0.001)。结论未来应注意控制社区老年人的体重,预防或减缓其进入衰弱前期或衰弱;同时仍应积极预防和控制心血管疾病。

Objectives:To examine the relationship between cardiovascular disease risk factors and frailty in a sample of older Chinese adults.Methods:A total of 458 community-dwelling older adults(>65 years)in Lanzhou,Gansu Province of China participated in a cross-sectional survey.Their status was evaluated in terms of frailty phenotype(unintentional weight loss,exhaustion,low activity levels,slowness and weakness).Participants were categorized as not frail,prefrail or frail.Cardiovascular disease risk factors that were assessed included:blood pressure,body mass index,waist circumference,blood glucose,total cholesterol,triglycerides,lowdensity lipoproteins and high-density lipoproteins.Results:Individuals with obesity had an increased risk of prefrailty(OR:2.26;95%CI:1.05,4.84).Hypertension was inversely associated with frailtyamong the participants(OR:0.31;95%CI:0.11,0.87)after adjusting for covariates.Conclusions:The findings suggest that much more attention should be paid to weight control of the elderly in the community for preventing them from transition to prefrailty or frailty.Active prevention and control of cardiovascular diseases among the community-dwelling elder are still of great importance.