健康老人四種衰弱指標與多面向老化功能風險評估之比較

Comparison of Four Frailty Indices with Multiple Aging Functional Risks in Healthy Elderly

10.6320/FJM.202007_24(4).0003

李昕怡(Hsin-Yi Li)；毛慧芬(Hui-Fen Mao)；陳永銘(Yung-Ming Chen)；陳慶餘(Ching-Yu Chen)

衰弱 ； 客觀衰弱檢測指標 ； 主觀衰弱檢測指標 ； 骨鬆衰弱檢測指標 ； 綜合衰弱檢測指標 ； 老化功能風險 ； 篩檢 ； 社區老人 ； frailty ； modified physical frailty index ； FRAIL frailty index ； study of osteoporotic fractures frailty index ； clinical frailty-deficits count index ； aging functional risk ； screening ； community-dwelling older adults

台灣醫學

24卷4期（2020 / 07 / 25）

371 - 382

繁體中文

本研究是首次針對樂齡寶貝機衰弱症自動化檢測軟體系統所測得四種衰弱檢測指標的結果，及其與各種功能衰弱風險之相關性作比較。以志願參加2018年台大醫院老人健檢70-79歲共254位長者為對象，使用衰弱症自動化檢測設備評估。採用四種衰弱檢測指標，篩檢此老人族群的衰弱盛行率，並分析與慢性疾病、生活型態、認知情緒、日常生活功能等29項各種老化風險評估指標之相關性，以瞭解四種衰弱檢測指標之間的差異。結果在這一群衰弱盛行率低的老人，四種衰弱檢測得出之衰弱比例，依序為綜合衰弱檢測（2.0％）、主觀身體衰弱檢測（1.2％）、客觀身體衰弱檢測（0.8％）和骨鬆衰弱檢測（0.8％）；與29項功能風險評估相關性結果如下，在綜合衰弱檢測出功能風險有22項相關最高，其次是主觀身體衰弱檢測出13項，客觀身體衰弱檢測出8項，骨鬆衰弱檢測出7項最低。另一方面，客觀身體衰弱檢測缺乏老年憂鬱檢測和評估的相關性，而骨鬆衰弱檢測缺乏老年認知和憂鬱風險的相關性。本研究結果顯示與3〜5項之主觀、客觀身體衰弱檢測及骨鬆衰弱檢測作比較，多面向的綜合衰弱檢測（共68項）與較多的功能衰弱風險顯著相關，因此臨床實務上，本研究結果建議衰弱的介入策略，應考慮包含多面向功能的衰弱風險評估，其結果可作為擬定衰弱老人個別化介入計畫之參考。

This was the first study to compare the ability of four frailty indices to identify frailty, and to investigate their correlations with varied functional risks as measured by Living Activities of Health Aging BabyBot (LAHA Bot) in community-dwelling older adults. Two-hundred and fifty-four healthy older adults aged 70 to 79 who underwent annual health checkups at National Taiwan University Hospital in 2018 participated this study. First, we assessed the prevalence of frailty using the four frailty indices, which were found to range from highest to the lowest as follows: modified physical frailty index (2.0%), FRAIL frailty index (1.2%), clinical frailty-deficits count index (0.8%) and SOF frailty index (0.8%). Second, we analyzed the correlations between each of the frailty indices and the 29 functional risks, such as chronic diseases, lifestyle, cognition, emotion, and activities of daily living. The results showed that the clinical frailty-deficits count index, associated with 22 functional risks, was the most relevant index, followed by FRAIL frailty index (13 risks), modified physical frailty index (8 risks), and SOF frailty index (7 risks). Furthermore, results showed that the modified physical frailty index was not associated with depressive risk, and the SOF frailty index was not associated with cognitive and depressive risks. The results showed that a multi-dimensional frailty index-namely the clinical frailty-deficits count index (68 items)-correlated with more functional risks than a 3- or 5-item simple frailty index (i.e. FRAIL frailty index, SOF frailty index, and clinical frailty-deficits count index). Therefore it was suggested that a multiple-dimension functional risks assessment for aging may be necessary before prescribing individualized frailty interventions.