| 刘晔,欧阳晓俊,胡健,等.衰老对老年患者内在能力影响及相关因素分析[J].中国临床保健杂志,2022,25(4):460-467. |
| 衰老对老年患者内在能力影响及相关因素分析 |
| Influence of aging on intrinsic ability of elderly patients and analysis of related factors |
| 投稿时间：2022-06-22 |
| DOI：10.3969/J.issn.1672-6790.2022.04.006 |
| 中文关键词: 衰老 年龄因素 危险因素 老年人 |
| 英文关键词: Aging Age factors Risk factors Aged |
| 基金项目:江苏省卫生健康委员会科研项目(H2019038) |
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| 中文摘要: |
| 目的 探讨不同年龄段老年患者内在能力差异特征,分析其内在能力受损的相关因素。方法 选取2019年8月1日至2021年5月31日在南京医科大学附属老年医院老年医学科长期随访管理的年龄 ≥70岁的患者356例,根据年龄分为70~＜80岁组、80~＜90岁组、90~99岁组,对所有患者记录一般临床资料,测 定人体测量指标和实验室指标,并进行内在能力评估,比较不同年龄组内在能力各维度差异,用受试者工作特 征曲线(ROC)分析内在能力各维度的诊断价值。依据内在能力评分将研究对象分为内在能力稳定组、轻度下 降组、重度下降组,进行内在能力下降程度相关影响因素的单因素分析,将差异有统计学意义的单因素纳入有 序logistic回归分析。结果 (1)老年患者中内在能力下降检出率为70.79%。随年龄增长,老年人内在能力呈 现明显下降趋势。(2)内在能力各维度ROC分析:不同年龄段中各维度对内在能力下降的诊断价值不同,70~＜80岁和80~＜90岁组中感觉维度对内在能力下降诊断价值最高(AUC值分别为0.761、0.868),90~99岁组中认知 维度对内在能力下降诊断价值最高(AUC值为0.870)。(3)单因素分析:内在能力不同组别之间性别、年龄、月 收入、居住状况、主要照料者、基础疾病种类均存在差异,3组体重指数、小腿围、握力、四肢骨骼肌指数、血红蛋 白、白蛋白、超敏C反应蛋白、游离三碘甲腺原氨酸比较,均差异有统计学意义(P值均<0.05)。(4)有序logistic回归分析:年龄、握力、游离三碘甲腺原氨酸是内在能力下降程度的保护因素。结论 老年患者内在能 力下降发生率较高且随年龄增长内在能力受损程度加重,70~＜90岁老人出现感觉维度下降,高度提示内在能力 受损,90~99岁老人出现认知功能下降高度提示内在能力受损,高龄、握力水平较低的老年患者为内在能力受 损的重点人群。 |
| 英文摘要: |
| Objective To investigate the differences in IC of elderly patients with different age and analyze the related factors of the decline of IC.Methods A total of 356 elderly patients with long-term follow-up management of the age of 70 or more in the Department of Geriatrics,Geriatric Hospital of Nanjing Medical University from August 1,2019 to May 31,2021 were selected.The patients were divided into 70-＜80 years old group,80-＜90 years old group,90-99 years old group based on ages.Their general clinical data,anthropometric and laboratory parameters were collected.The IC of elderly patients were evaluated.The differences in each dimension of IC among the three age groups were compared.The receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of each dimension of IC.The patients were divided into high and stable intrinsic capacity group,declining capacity group and significant loss of capacity group according to the IC score.Firstly,the single factor of influencing factors related to the decline of intrinsic ability was analyzed,and then the single factor with statistical difference was included in the ordered logistic regression analysis.Results (1) The detection rate of IC decline in elderly patients was 70.79%,The IC of the elderly shows a significant downward trend with increasing age.(2) ROC analysis:The sensory dimension had the highest diagnostic value for the decline in IC in the 70-＜80 and 80-＜90 years old groups (AUC:0.761,0.868),and the cognitive dimension had the highest diagnostic value for the decline IC in the 90-99 years old group (AUC:0.870).(3) Univariate analysis:there were differences in gender,age,monthly income,living conditions,primary caregivers,and types of underlying diseases among the different groups of IC;Also statistically significant differences were found in the three groups in BMI,calf circumference,grip strength,ASMI,Hb,ALB,hs-CRP and FT3 (all P<0.05).(4) Ordinal logistic regression analysis:age,grip strength,and FT3 were protective factors for the degree of IC decline.Conclusions Elderly patients have a higher incidence of decreased IC,which increases with age.A decline in sensory dimension in the 70-＜90 yeasr old is highly indicative of impaired IC.Cognitive decline in 90-99 years old is highly indicative of impaired IC.Older patients and elderly patients with lower grip strength are the key populations with decreased IC. |
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