Progress in Research on the Trajectory of Frailty and Its Influencing Factors

doi:10.12114/j.issn.1007-9572.2024.0586

Abstract

Abstract:

Frailty is a geriatric syndrome associated with aging, which increases the risk of adverse events in the elderly. With the progress of population aging, the problem of frailty has been widely concerned. Previous studies mainly focused on frailty, mainly cross-sectional studies, and the studies on frailty trajectory (clustering of individuals with similar frailty over time) and its influencing factors were not clear, and the measures for early intervention of frailty through these studies were not clear. This paper summarized the latest clinical research progress of the risk factors of the frailty trajectory, in order to analyze the factors affecting the frailty trajectory from different angles, and provide new ideas for the comprehensive management of patients with frailty.

Key words: Frailty, Trajectory of frailty, Longitudinal studies, Risk factors, Review

摘要：

衰弱是一种与衰老相关的老年问题，会增加老年人发生不良事件的风险。随着人口老龄化进程的推进，衰弱问题受到了广泛关注。以往的研究主要集中在衰弱性上，以横断面研究为主，对衰弱轨迹（具有相似衰弱性的个体随时间的聚类）及其影响因素的研究并不明确，通过这些研究对衰弱进行早期干预的措施也不明确。本文总结了衰弱轨迹的危险因素最新临床研究进展，以期从不同角度分析影响衰弱轨迹的因素，为衰弱患者的综合管理提供新的思路。

关键词: 衰弱, 衰弱轨迹, 纵向研究, 危险因素, 综述

CLC Number:

R 364

HE Yang,YANG Rong,SHEN Can, et al. Progress in Research on the Trajectory of Frailty and Its Influencing Factors[J]. Chinese General Practice, 2026, 29(30): 4372-4378. DOI: 10.12114/j.issn.1007-9572.2024.0586.
贺洋,杨荣,沈灿等. 衰弱轨迹及其影响因素研究进展[J]. 中国全科医学, 2026, 29(30): 4372-4378. DOI: 10.12114/j.issn.1007-9572.2024.0586.

Figures/Tables 1

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评估工具	衰弱指数	Fried衰弱表型	Edmonton衰弱量表
包含内容	自我报告的健康状况、老年综合评估、基本和日常生活活动受限、视力和听力评估、行走平衡功能、既往诊断的疾病和使用的药物、日常生活活动能力、认知和情绪、抑郁、身体测量指标等30~92个健康变量（每个变量赋值1分）	①体质量下降：近半年内意外出现体质量下降>5 kg或>5%的体质量。②步速减慢：测量步行6 m所需的时间，计算步速，步速≤0.8 m/s为行走速度减慢。③握力下降：使用电子握力器测量优势手的握力，根据不同年龄、不同性别的握力标准进行判断。④活动量减少：调查研究对象在过去1周内的活动量，男性<383 kcal/周，女性<270 kcal/周为躯体活动量下降。⑤疲乏：使用以下2个问题中的1个进行评估：a.我感觉我做每一件事情都需要经过努力；b.我不能向前行走	①画钟测试2分；②住院次数2分；③健康状况2分；④日常活动是否需要他人帮助2分；⑤当需要帮助时，是否能找到帮助你的人2分；⑥是否服用5种以上处方药1分；⑦经常忘记服用药物1分；⑧因体质量减轻而感到衣服宽松1分；⑨情绪是否低落1分；⑩是否能控制住大小便1分；⑪能够独自完成体力劳动1分，步行2层楼梯或步行1 000 m 1分
计算方法	个体的健康缺陷数目除以健康缺陷总数的数值	"是"计1分，"否"计0分；总分范围为0~5分	①~⑤每项"是"计2分，"否"计0分；⑥~⑪每项"是"计1分，"否"计0分；总分范围为0~17分
结果解读	健康期（衰弱指数≤0.10）、衰弱前期（0.10<衰弱指数<0.25）和衰弱期（衰弱指数≥0.25）	0分为无衰弱，1~2分为衰弱前期，≥3分为衰弱	0~4分表示无衰弱，5~6分表示易出现衰弱的敏感人群，7~8分表示轻度衰弱，9~10分表示中度衰弱，11分或以上表示严重衰弱
优缺点	应用范围与评估维度广泛，更符合现代生物-心理-社会医学模式，但由于其需要评估的内容过多且繁琐，调查所需要的时间较长，更容易产生混杂干扰	侧重于老年人的生物学表现，观测指标数量不多且能客观定量，操作性较强，适用于临床机构应用；但该模式存在不足之处在于以及认知障碍等其他构成衰弱的躯体外因素未纳入测量范围	评估一般在5 min之内便可完成，简单便捷；但该量表中"健康状况"过于主观且不稳定

评估工具	衰弱指数	Fried衰弱表型	Edmonton衰弱量表
包含内容	自我报告的健康状况、老年综合评估、基本和日常生活活动受限、视力和听力评估、行走平衡功能、既往诊断的疾病和使用的药物、日常生活活动能力、认知和情绪、抑郁、身体测量指标等30~92个健康变量（每个变量赋值1分）	①体质量下降：近半年内意外出现体质量下降>5 kg或>5%的体质量。②步速减慢：测量步行6 m所需的时间，计算步速，步速≤0.8 m/s为行走速度减慢。③握力下降：使用电子握力器测量优势手的握力，根据不同年龄、不同性别的握力标准进行判断。④活动量减少：调查研究对象在过去1周内的活动量，男性<383 kcal/周，女性<270 kcal/周为躯体活动量下降。⑤疲乏：使用以下2个问题中的1个进行评估：a.我感觉我做每一件事情都需要经过努力；b.我不能向前行走	①画钟测试2分；②住院次数2分；③健康状况2分；④日常活动是否需要他人帮助2分；⑤当需要帮助时，是否能找到帮助你的人2分；⑥是否服用5种以上处方药1分；⑦经常忘记服用药物1分；⑧因体质量减轻而感到衣服宽松1分；⑨情绪是否低落1分；⑩是否能控制住大小便1分；⑪能够独自完成体力劳动1分，步行2层楼梯或步行1 000 m 1分
计算方法	个体的健康缺陷数目除以健康缺陷总数的数值	"是"计1分，"否"计0分；总分范围为0~5分	①~⑤每项"是"计2分，"否"计0分；⑥~⑪每项"是"计1分，"否"计0分；总分范围为0~17分
结果解读	健康期（衰弱指数≤0.10）、衰弱前期（0.10<衰弱指数<0.25）和衰弱期（衰弱指数≥0.25）	0分为无衰弱，1~2分为衰弱前期，≥3分为衰弱	0~4分表示无衰弱，5~6分表示易出现衰弱的敏感人群，7~8分表示轻度衰弱，9~10分表示中度衰弱，11分或以上表示严重衰弱
优缺点	应用范围与评估维度广泛，更符合现代生物-心理-社会医学模式，但由于其需要评估的内容过多且繁琐，调查所需要的时间较长，更容易产生混杂干扰	侧重于老年人的生物学表现，观测指标数量不多且能客观定量，操作性较强，适用于临床机构应用；但该模式存在不足之处在于以及认知障碍等其他构成衰弱的躯体外因素未纳入测量范围	评估一般在5 min之内便可完成，简单便捷；但该量表中"健康状况"过于主观且不稳定