論文標題：Association between anemia and frailty in 13,175 community-dwelling adults aged 50 years and older in China

期刊：BMC Geriatrics

作者：Ye Ruan, Yanfei Guo et.al

發表時間：2019/12/04

數字識別碼：10.1186/s12877-019-1342-5

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中國的老年人口在迅速增長，人均預期壽命已從1950年的44.6歲增加到2015年的75.3歲，到2050年會接近80歲。隨著人口的老齡化，社會的總體疾病負擔開始轉化成以慢性非傳染性疾病為主。貧血和虛弱是導致老年人健康惡化的因素。貧血定義為男性的血紅蛋白低于每分升13克，女性低于每分升12克。貧血的癥狀包括疲勞感增強，認知能力降低，肌肉力量減弱等，這些因素也使老年人更加虛弱。

然而，目前在低收入國家中進行的研究大多只關注貧血或虛弱，而缺乏對兩者的綜合考慮。發表在BMC Geriatrics的Association between anemia and frailty in 13,175 community-dwelling adults aged 50 years and older in China 旨在評估世界衛生組織《全球老齡化與成人健康研究》中國項目第一輪調查里研究過的13175名50歲及50歲以上社區居民群里貧血與虛弱的關系。研究人員定義虛弱指數（FI）評估參與者的虛弱程度，并用 2級分層邏輯模型評估貧血和虛弱之間的關聯。

圖1

本研究發現貧血和低血紅蛋白濃度與虛弱有明顯的關聯。參與者貧血患病率為31.0％（95％置信區間：28.4，33.8％），虛弱的患病率為14.7％（95％置信區間：13.5，16.0％）。在單變量回歸模型中，貧血與虛弱有明顯的關聯（比值比 = 1.62，95％置信區間：1.39，1.90）。在調整了各種可能的干擾因素，包括年齡、性別、住址、教育程度、家庭經濟情況、水果和蔬菜的攝入量、煙草和酒精的使用以及運動量以后，該結論仍然保持一致 （調整后的比值比為1.31，95％置信區間：1.09，1.57）。參與者的血紅蛋白濃度每增加每分升1克，其患虛弱幾率就會降低4％（調整后的比值比為0.96，95％置信區間：0.93，0.99）。因此，照顧老年人的醫療保健專業人員應增加對貧血患者的篩查、評估及治療以此避免、延緩甚至扭轉虛弱的。

貧血和虛弱在老人群內并存的現象對全球的醫療系統帶來了潛在的挑戰。最近的一項薈萃分析估計，有貧血的老年人也患有虛弱的幾率比一般老人要高出一倍以上，該篇文章是首次在中國開展的有代表性的研究來評估貧血與虛弱在中國社區的老年人群內的關系。

注解：Rockwood的虛弱指數（FI）是30-40個臨床變量的缺陷的積累。Fried建議通過五種癥狀（無意識的體重減輕，虛弱，耐力和精力不佳，緩慢和低運動量）中的至少三種來識別脆弱的表型。根據不同的評估方法和地理區域，虛弱的患病率從4％到59.1％不等。

圖2

BMC Geriatrics is an open access journal publishing original peer-reviewed research articles in all aspects of the health and healthcare of older people, including the effects of healthcare systems and policies. The journal also welcomes research focused on the aging process, including cellular, genetic, and physiological processes and cognitive modifications.

Journal Metrics

2-year IF:2.818

5-year IF:3.458

SNIP :1.420

SJR:1.352

摘要：

Background

Anemia and frailty contribute to poor health outcomes in older adults; however, most current research in lower income countries has concentrated on anemia or frailty alone rather than in combination. The aim of the present study was to investigate the association between anemia and frailty in community-dwelling adults aged 50 years and older in China.

Methods

The study population was sourced from the 2007/10 SAGE China Wave 1. Anemia was defined as hemoglobin less than 13g/dL for men and less than 12g/dL for women. A Frailty Index (FI) was compiled to assess frailty. The association between anemia and frailty was evaluated using a 2-level hierarchical logistic model.

Results

The prevalence of anemia was 31.0% (95%CI: 28.4, 33.8%) and frailty 14.7% (95%CI: 13.5, 16.0%). In the univariate regression model, presence of anemia was significantly associated with frailty (OR=1.62, 95% CI: 1.39, 1.90) and the effect remained consistent after adjusting for various potential confounding factors including age, gender, residence, education, household wealth, fruit and vegetable intake, tobacco use, alcohol comsumption and physical activity (adjusted OR=1.31, 95% CI:1.09, 1.57). Each 1g/dL increase in hemoglobin concentration was associated with 4% decrease in the odds of frailty after adjusting for several confounding variables (adjusted OR=0.96,95% CI: 0.93, 0.99).

Conclusion

Anemia and low hemoglobin concentrations were significantly associated with frailty. Therefore, health care professionals caring for older adults should increase screening, assessment of causes and treatment of anemia as one method of avoiding, delaying or even reversing frailty.

（來源：科學網）