关键词: 衰弱, 老年人, 社区, 慢性病, 认知, 抑郁, 日常生活活动, 影响因素分析

Abstract: Background　Frailty is a term that describes a decrease in physiological function that results in dependency，which can be dynamic and reversible. Frailty is closely correlated with adverse health outcomes in older people，so it is particularly important to early identify frailty，and deliver interventions targeting its influencing factors in this group in a rapidly ageing world. Objective　To investigate the frailty prevalence and influencing factors in the elderly in the community，providing evidence for the development of interventions for frailty in this population. Methods　This household survey was carried out from June 2018 to June 2019 by eligible physicians with relevant trainings with the help of the neighborhood committee. Participants（n=600） were randomly selected from a random sample of 6 moderate-income communities with the assistance of Taiyuan Health Commission. The questionnaire used for collecting data includes three parts：general information，geriatric syndrome-related assessment〔Mini Nutritional Assessment-short Form（MNA-SF），Mini-mental State Examination（MMSE），Zung Self-rating Anxiety Scale（SAS），Zung Self-rating Depression Scale（SDS），Athens Insomnia Scale，Activities of Daily Living（ADL） Scale〕，and the FRAIL Scale. Multivariate ordinal Logistic regression analysis was adopted to analyze the influencing factors of frailty. Results　Altogether，513（85.5%） cases who responded to the survey effectively were included in the final analysis. Of the respondents，431（84.0%） were robust，63（12.3%） were pre-frail，and 19（3.7%） were frail. The prevalence of frailty among the respondents differed significantly by age，education level，living environment，swallowing function，number of chronic diseases，nutritional status，cognitive function，anxiety status，depression status，sleep status，and level of independence in ADLs（P<0.05）. Multivariate ordinal Logistic regression analysis found that number of chronic diseases〔OR=1.455，95%CI（1.071，1.974）〕，cognitive function 〔OR=0.915，95%CI（0.855，0.979）〕，depression〔OR=2.563，95%CI（1.185，5.540）〕，level of independence in ADLs 〔some dependency：OR=2.487，95%CI（1.310，4.721）；very dependant：OR=11.485，95%CI（4.424，29.815）〕 were the influencing factors of frailty（P<0.05）. Conclusion　The frailty of elderly in the community are affected by the number of combined chronic diseases，cognitive function，depression，and ability to perform ADL. Interventions for reducing the risk of frailty may be delivered based on the above-mentioned frailty-related factors.

Key words: Frailty, Aged, Community, Chronic disease, Cognition, Depression, Activities of daily living, Root cause analysis