電子期刊
台灣家庭醫學雜誌
Shin-Yu Shih1, Hsin-Yin Hsu1,2, Hsin-Lung Chan1,2, Lee-Ching Hwang1,2,Jin-Jin Tjung1, Meng-Ting Tsou1,3* and Ching-Ping Hsu1,2*
Methods: The data were collected from participants aged 65 years and older whounderwent health examinations between 2017 to 2018. Standard questionnaires ofpersonal and past medical history, including fall history, were administered.Functional assessments incorporate the Fried Frailty Index, Patient HealthQuestionnaire-2 (PHQ-2), Mini Nutritional Assessment (MNA), and the 30-secondsit-to-stand test. The participants were divided into non-frail group and frailty group,which included prefrail and frail patients.
Results: A total of 1,366 participants were included in the study, among whom 773were non-frail (56.6%) and 593 were either pre-frail (41.2%) or frail (2.2%).Univariable analysis revealed that older age, low educational, current alcoholdrinking habit, poor nutritional status, lack of exercise, abnormal depressionscreening, and history of hypertension (HTN) and cardiovascular disease (CVD)were associated with higher risk of frailty. No significant association was foundbetween frailty and biomarkers including glucose and lipid profile, nor the presenceof metabolic syndrome. Multivariable logistic regression indicated that participantswith poor nutritional status (odds ratio [OR] 2.40, 95% confidence interval [CI] 1.27–4.53), a positive PHQ-2 screening (OR of 3.60, 95% CI 1.27–10.16), and a historyof CVD (OR 1.47, 95% CI 1.01–2.12) were associated with higher frailty scores.
Conclusion: This study identified that old adults who had poor nutritional status, apositive PHQ-2 screening result, and a history of CVD tend to have a higherprobability of frailty in older adults.
(Taiwan J Fam Med 2025; 35:116-131) DOI: 10.53106/168232812025063502005
Key words: cardiovascular disease, depression, frailty, nutrition
1Department of Family Medicine, Mackay Memorial Hospital
2Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
3MacKay Junior College of Medicine, Nursing and Management
Received: December 30, 2024; Revised: January 29, 2025; Accepted: February 23, 2025.
*Corresponding authors: Meng-Ting Tsou, Ching-Ping Hsu; Department of Family Medicine, Mackay Memorial Hospital.
E-mail: mttsou@gmail.com; mama.anna74@gmail.com
新北市某醫學中心長者衰弱症的危險因子分析
施欣妤1 許馨尹1,2 詹欣隆1,2 黃麗卿1,2 鍾嫈嫈1鄒孟婷1,3* 徐慶玶1,2*
背景:過去研究發現衰弱前期和衰弱症長者跌倒及住院風險,死亡率都相對較高。本研究目的在探討衰弱症的危險因子,以期臨床工作者及早發現衰弱前期及衰弱症長者,改善長者生活品質。
方法:本研究收集2017~2018年間,接受健康檢查的65歲以上長者,完整回答包含過去病史,營養評估,運動習慣,教育程度,憂鬱篩檢,跌倒次數,衰弱篩檢之問卷,接受抽血檢驗包含血糖及血脂項目,且接受30秒內起立坐下測試者為分析對象。將受檢者依衰弱指標分為非衰弱組,以及包含衰弱前期與衰弱症的衰弱組,分析各變項與衰弱的相關性。
結果:共1,366名檢查受試者符合以上條件,其中773名無衰弱(56.6%),593名為衰弱前期(41.2%)及衰弱症(2.2%)長者。在單變項分析中,發現年紀較大、教育程度較低、具飲酒習慣、高血壓病史、心血管病史、營養狀態不佳、缺乏運動習慣、憂鬱量表異常之受檢者,衰弱風險較高。在多變項邏輯回歸檢定中,營養狀態不良者(勝算比2.40, 95%信賴區間 1.27-4.53)、憂鬱篩檢異常者(勝算比3.60 ,95%信賴區間 1.27-10.16) ,以及患有心血管疾病者(勝算比為1.47,95%信賴區間 1.01-2.12),衰弱風險較高。
結論:本研究發現長者營養狀態不良,憂鬱篩檢量表異常,或患有心血管疾病者,衰弱風險較高。除了常規的血液檢查外,臨床醫師面對高齡長者,可定期評估營養、肌力、情緒及衰弱指標,早期辨識衰弱風險較高的長者,以減少長者未來失能,改善生活品質。
(台灣家醫誌2025; 35: 116-131) DOI: 10.53106/168232812025063502005
關鍵詞:衰弱、營養評估、憂鬱症篩檢、心血管疾病
1馬偕紀念醫院家庭醫學科
2馬偕醫學院醫學系
3馬偕醫護管理專科學校
受理日期:113年12月30日 修改日期:114年1月29日 同意刊登:114年2月23日
*通訊作者