老年共病患者衰弱患病率的Meta分析
【摘要】 背景 随着老龄化问题日益严峻，老年共病的患病率正呈现逐年上升趋势。老年共病是导致衰弱的关键危险因素，衰弱的发生会使得共病患者提高一系列不良健康结局的风险，同时也会增加患者家庭的医疗费用支出。尽早识别老年共病患者的衰弱患病情况，对慢性病共病管理具有一定的指导价值。目的 系统评价老年共病患者衰弱的患病率。方法 计算机检索中国知网、维普网、中国生物医学文献数据库、万方数据知识服务平台、Pubmed、Embase、Web of Science及The Cochrane Library数据库中关于老年共病患者衰弱现状调查的研究，检索时间为建库至2021年12月4日。提取数据并评价纳入研究的文献质量，采用Stata 14.0软件进行Meta分析。结果 共纳入25项研究，包含16062名老年共病患者。Meta分析结果显示，老年共病患者衰弱及衰弱前期患病率分别为27%[95%CI(22%,32%)]、48%[95%CI(44%,51%)]。亚组分析结果显示，共存2种及以上慢性疾病的老年人衰弱患病率为25%[95%CI(19%,31%)]，3种及以上患病率为27%[95%CI(14%,41%)]，4种及以上患病率为42%[95%CI(-2%,87%)]；大洋洲衰弱患病率（52%）和亚洲衰弱患病率（31%）高于欧洲衰弱患病率（17%）、南美洲衰弱患病率（13% ）；医院老年共病患者衰弱患病率（26%）高于社区患病率（23%）；应用临床衰弱量表(CFS)筛查老年共病患者衰弱患病率为43%[95%CI(38%,47%)]，Fried衰弱表型量表的衰弱患病率为22%[95%CI(18%,27%)]，FRAIL量表的衰弱患病率为8%[95%CI(6%,11%)]；调查时间为2001-2010、2011-2015、2016-2020年组的衰弱患病率分别为21%[95%CI(13%,29%)]、19%[95%CI(13%,25%)]、38%[95%CI(23%,53%)]。结论 老年共病患者衰弱患病率正逐渐上升，不同共病数量、洲区、评估工具、研究场所存在差异。因此，相关人员应重视共病患者衰弱的早期筛查，并及时采取预防措施。
Background The prevalence of comorbiditiy in the elderly is showing a gradual upward trend with the acceleration of population aging.Comorbidity is a key risk factor for frailty.Then frailty will not only increase the risk of adverse health outcomes for patients, but also exert a heavy economic burden on patients' families.It has a certain guiding value for the management of chronic diseases to identify the frailty conditions of elderly patients with comorbidity as early as possible.Objective To systematically evaluate the prevalence of frailty in elderly patients with comorbidity.Methods We searched studies regarding frailty in elderly patients with comorbidity published from inception to December 4,2021,and CNKIVIPCBMWanFangPubmedEmbaseWeb of Science and The Cochrane Library of the databases were included.Data extraction and quality evaluation of the included studies were performed.Stata 14.0 was used for statistical analysis.Results A total of 25 studies involving 16062 subjects were included.Meta-analysis showed that the prevalence of frailty and pre-frailty in elderly patients with comorbidity was 27%[95%CI(22%,32%)] and 48%[95%CI(44%,51%)].Subgroup analysis showed that the prevalence of 2,3 and 4 chronic diseases was 25%[95%CI(19%,31%)],27%[95%CI(14%,41%)],and 42%[95%CI(-2%,87%)].Oceania(52%) and Asia(31%) had higher overall prevalence of frailty in elderly patients with comorbidity than Europe(17%) and South America(13%).Hospital had higher overall prevalence of frailty in elderly patients with comorbidity than community(26% vs 23%).The prevalence of frailty in elderly patients with comorbidity was screened 43%[95%CI(38%,47%)] by Clinical Frailty Scale,22%[95%CI(18%,27%)] by FRAIL,and 8%[95%CI(6%,11%)] by Fried.The prevalence for patients surveyed between 2001-2010,2011-2015,and 2016-2020 was 21%[95%CI(13%,29%)],19%[95%CI(13%,25%)] and 38%[95%CI(23%,53%)],respectively.Conclusion The prevalence of of frailty in elderly patients with comorbidity is increasing year by year,with differences by number of chronic diseases,continents,assessment tools and study sites.Therefore,relevant personnel should pay attention to early screening of frailty in elderly patients with comorbidity and provide targeted preventive measures for them.
林洋, 王芳, 王寒, 武蓉, 王瑶, 徐子尧, 王旭, 王彦丁
10.12114/j.issn.1007-9572.2022.0521
医学研究方法医药卫生理论
衰弱老年人共病Meta分析
林洋, 王芳, 王寒, 武蓉, 王瑶, 徐子尧, 王旭, 王彦丁.老年共病患者衰弱患病率的Meta分析[EB/OL].(2022-08-01)[2025-08-02].https://chinaxiv.org/abs/202208.00015.点此复制
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