Abstract: Background　White matter hyperintensity （WMH） is more likely to occur in the elderly. It is hidden-onset，and its progression eventually leads to poor prognosis. Frailty is a common geriatric syndrome，which is strongly associated with adverse health events in the elderly. Few studies have focused on frailty in elderly WMH inpatients. Objective　To investigate the prevalence and influencing factors of frailty in elderly hospitalized patients with WMH. Methods　By use of purposive sampling method，totally 321 neurology inpatients with WMH aged 60 years or above were selected from the Affiliated Hospital of Guizhou Medical University，and Guizhou Provincial People's Hospital from December 2019 to June 2020. A self-designed General Data Questionnaire was used to collect general data. The FRAIL Scale，Barthel Index，and Morse Fall Scale were used to assess frailty，functional independence，and risk of falling，respectively. Early morning fasting venous blood samples were obtained to test laboratory indicators. WMH was detected by brain MRI，and quantified by the Fazekas Scale. Binary Logistic regression analysis was used to investigate the influencing factors of frailty. Results　Of the 321 cases，129 （40.2%） were found with frailty，and the other 192 （59.8%） without. Binary Logistic regression analysis showed that older age〔80 or older：OR=3.597，95%CI （1.330，9.730）〕，high risk of falling〔>45 points：OR=12.509，95%CI（6.460，24.221）〕and Fazekas grade of WMH〔grade 2：OR=5.503，95%CI （2.638，11.479）；grade 3：OR=6.981，95%CI （2.977，16.368）〕were associated with increased risk of frailty（P<0.05），while hemoglobin〔male≥120 g/L，female≥110 g/L：OR=0.260，95%CI （0.092，0.732）〕，and prealbumin〔≥180 mg/L：OR=0.221，95%CI （0.078，0.625）〕were associated with decreased risk of frailty （P<0.05）. Conclusion　The prevalence of frailty in this population was high. In view of this，healthcare workers should pay attention to frailty assessment in elderly hospitalized patients with WMH，especially those who are older，having high risk of falling，Fazekas grade over 1，abnormal level of hemoglobin and/or prealbumin，so as to develop a more scientific and rational management plan. Early prevention and timely intervention may be a scientific approach to improving frailty and other health-related management of such patients.

Key words: Leukoencephalopathies, White matter hyperintensities, Frailty, Aged, Root cause analysis

摘要： 背景　脑白质高信号（WMH）易发生于老年人群，且发病隐匿，随病情的进展最终导致不良预后。衰弱是一种常见的老年综合征，与老年人不良健康事件的发生紧密相关。目前少有研究关注WMH老年住院患者的衰弱状况。目的　调查WMH老年住院患者的衰弱现状，分析其影响因素。方法　采用目的抽样法选取2019年12月—2020年6月在贵州医科大学附属医院、贵州省人民医院神经内科病房住院的年龄≥60岁的321例WMH患者为研究对象。采用自制的一般资料调查表收集一般资料，分别采用衰弱筛查量表（FRAIL）、Barthel指数量表（BI）、Morse跌倒评估量表（MFS）评估衰弱、日常生活活动能力、跌倒风险。抽取患者清晨静脉血进行实验室检查。对患者进行影像学检查，根据Fazekas量表进行WMH分级。采用二分类Logistic回归分析探讨WMH老年住院患者衰弱的影响因素。结果　321例WMH老年住院患者中衰弱129例（40.2%）、非衰弱192例（59.8%）。二分类Logistic回归分析结果显示，高龄〔≥80岁：OR=3.597，95%CI（1.330，9.730）〕、高度跌倒风险〔>45分：OR=12.509，95%CI（6.460，24.221）〕、WMH分级〔2级：OR=5.503，95%CI（2.638，11.479）；3级：OR=6.981，95%CI（2.977，16.368）〕是WMH老年住院患者衰弱的危险因素（P<0.05），血红蛋白（HGB）〔男≥120 g/L、女≥110 g/L：OR=0.260，95%CI（0.092，0.732）〕、前白蛋白（PA）〔≥180 mg/L：OR=0.221，95%CI（0.078，0.625）〕是WMH老年住院患者衰弱的保护因素（P<0.05）。结论　WMH老年住院患者衰弱发生率较高，医护人员应重视WMH老年住院患者衰弱状况的评估，高度关注高龄、有高度跌倒风险、WMH分级>1级、HGB与PA异常的WMH老年住院患者，进而制定更为科学合理的护理计划，早期预防，及时干预，改善和管理WMH老年患者的衰弱情况，为患者的健康管理提供科学依据。

关键词: 脑白质病, 脑白质高信号, 衰弱, 老年人, 影响因素分析