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学科主题: 精神卫生
题名:
Frailty and the prediction of dependence and mortality in low- and middle-income countries: a 10/66 population-based cohort study
作者: Jotheeswaran, A. T.1,2,12; Bryce, Renata1,2; Prina, Matthew1,2; Acosta, Daisy3; Ferri, Cleusa P.4,5; Guerra, Mariella6; Huang, Yueqin7; Llibre Rodriguez, Juan J.8; Salas, Aquiles9; Luisa Sosa, Ana10; Williams, Joseph D.11; Dewey, Michael E.1,2; Acosta, Isaac10; Liu, Zhaorui7; Beard, John13; Prince, Martin1,2
关键词: Aged ; Frailty ; Developing countries ; Disability ; Geriatric assessment ; Epidemiology ; Long-term care ; Mortality
刊名: BMC MEDICINE
发表日期: 2015-06-10
DOI: 10.1186/s12916-015-0378-4
卷: 13
收录类别: SCI ; SSCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: DWELLING OLDER-PEOPLE ; OF-THE-LITERATURE ; COGNITIVE IMPAIRMENT ; FUNCTIONAL DECLINE ; CHRONIC DISEASES ; ELDERLY-PEOPLE ; LATIN-AMERICA ; TELL US ; DISABILITY ; HEALTH
英文摘要:

Background: In countries with high incomes, frailty indicators predict adverse outcomes in older people, despite a lack of consensus on definition or measurement. We tested the predictive validity of physical and multidimensional frailty phenotypes in settings in Latin America, India, and China.

Methods: Population-based cohort studies were conducted in catchment area sites in Cuba, Dominican Republic, Venezuela, Mexico, Peru, India, and China. Seven frailty indicators, namely gait speed, self-reported exhaustion, weight loss, low energy expenditure, undernutrition, cognitive, and sensory impairment were assessed to estimate frailty phenotypes. Mortality and onset of dependence were ascertained after a median of 3.9 years.

Results: Overall, 13,924 older people were assessed at baseline, with 47,438 person-years follow-up for mortality and 30,689 for dependence. Both frailty phenotypes predicted the onset of dependence and mortality, even adjusting for chronic diseases and disability, with little heterogeneity of effect among sites. However, population attributable fractions (PAF) summarising etiologic force were highest for the aggregate effect of the individual indicators, as opposed to either the number of indicators or the dichotomised frailty phenotypes. The aggregate of all seven indicators provided the best overall prediction (weighted mean PAF 41.8 % for dependence and 38.3 % for mortality). While weight loss, underactivity, slow walking speed, and cognitive impairment predicted both outcomes, whereas undernutrition predicted only mortality and sensory impairment only dependence. Exhaustion predicted neither outcome.

Conclusions: Simply assessed frailty indicators identify older people at risk of dependence and mortality, beyond information provided by chronic disease diagnoses and disability. Frailty is likely to be multidimensional. A better understanding of the construct and pathways to adverse outcomes could inform multidimensional assessment and intervention to prevent or manage dependence in frail older people, with potential to add life to years, and years to life.

语种: 英语
所属项目编号: GR066133 ; IIRG-04-1286
项目资助者: Wellcome Trust (UK) ; World Health Organisation ; US Alzheimer&prime ; s Association ; Fondo Nacional de Ciencia Y Tecnologia, Consejo de Desarrollo Cientifico Y Humanistico, Universidad Central de Venezuela (Venezuela) ; Wellcome Trust Capacity Strengthening Strategic Award ; consortium of UK universities
WOS记录号: WOS:000356764000001
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55039
Appears in Collections:北京大学精神卫生研究所_期刊论文

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作者单位: 1.WHO, Dept Ageing & Life Course, CH-27 Geneva, Switzerland
2.Univ Fed Sao Paulo, Dept Psychobiol, BR-04024002 Sao Paulo, SP, Brazil
3.Inst Memoria & Desordenes Relacionados, Lima, Peru
4.Peking Univ, Inst Mental Hlth, Beijing 100083, Peoples R China
5.Kings Coll London, Hlth Serv, Ctr Global Mental Hlth, London SE5 8AF, England
6.Kings Coll London, Populat Res Dept, Inst Psychiat, London SE5 8AF, England
7.Univ Nacl Pedro Henriquez Urena, Dept Internal Med, Geriatr Sect, Santo Domingo 1423, Dominican Rep
8.Hosp Alemao Oswaldo Cruz, Inst Educ & Hlth Sci, BR-01323903 Sao Paulo, SP, Brazil
9.Med Univ Havana, Fac Med Finley Albarran, Havana, Cuba
10.Univ Cent Venezuela Edif, Dept Med, Fac Med, Caracas Univ Hosp,Decanato Med, Caracas 9995, Venezuela
11.Univ Nacl Autonoma Mexico, Natl Inst Neurol & Neurosurg Mexico, Coyoacan 4510, Mexico
12.Voluntary Hlth Serv, Madras 6000113, Tamil Nadu, India
13.Indian Inst Publ Hlth Hyderabad, Amar Cooperat Soc, Publ Hlth Fdn India, Hyderabad 500033, Andhra Pradesh, India

Recommended Citation:
Jotheeswaran, A. T.,Bryce, Renata,Prina, Matthew,et al. Frailty and the prediction of dependence and mortality in low- and middle-income countries: a 10/66 population-based cohort study[J]. BMC MEDICINE,2015,13.
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