Correlation analysis of frailty syndrome and lower limb motor function in hospitalized elderly patients_West China Medical Journal

Authors：

CHUN Xueli ¹ , PENG Chunlan ² , LI Qian ² , HU Cuilin ² , ZHOU Qianyun ² , XU Qinyue ² , LIANG Yuxiang ³ ,  HUANG Wenxia ⁴

1. West China School of Nursing, Sichuan University / Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
4. Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

HUANG Wenxia, Email: 1437454655@qq.com

Keywords：

Elderly impatient; frailty; lower limb motor function

DOI：

10.7507/1002-0179.202306060

Video：

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Objective To analyze the correlation between frailty syndrome and lower limb motor function in hospitalized elderly patients. Methods Convenience sampling method was used to select inpatients aged 65 and above from the Center of Gerontology and Geriatrics of West China Hospital, Sichuan University between December 2022 and May 2023. The FRAIL Scale, Short Physical Performance Battery (SPPB), and Timed Up and Go Test (TUGT) were used to evaluate the degree of frailty and lower limb motor function, and to explore the correlation between frailty and lower limb motor function. Results A total of 501 elderly patients were included, including 325 males (64.9%) and 176 females (35.1%); 256 cases of frailty (51.1%), 161 cases of pre-frailty (32.1%), and 84 cases of non-frailty (16.8%). The incidence of frailty in hospitalized elderly male patients was higher than that in female patients (P<0.05); The incidence of frailty in patients aged 80-99 was higher than that in patients aged 65-79 (P<0.05). The Spearman correlation analysis results showed that all dimensions of SPPB were negatively correlated with frailty (P<0.001), while TUGT was positively correlated with frailty (r=0.776, P<0.001). The results of multiple linear regression analysis showed that the worse the motor function of the lower limbs, the higher the debilitation score. Conclusions Frailty syndrome in hospitalized elderly patients is closely related to lower limb motor function. Lower limb motor function assessment can be used to predict the onset of frailty in clinical practice, and interventions to improve lower limb motor function can be used to improve the frailty of elderly patients.

Citation： CHUN Xueli, PENG Chunlan, LI Qian, HU Cuilin, ZHOU Qianyun, XU Qinyue, LIANG Yuxiang, HUANG Wenxia. Correlation analysis of frailty syndrome and lower limb motor function in hospitalized elderly patients. West China Medical Journal, 2024, 39(1): 42-47. doi: 10.7507/1002-0179.202306060 Copy

1.	Walston J, Bandeen-Roche K, Buta B, et al. Moving frailty toward clinical practice: NIA intramural frailty science symposium summary. J Am Geriatr Soc, 2019, 67(8): 1559-1564.
2.	黃小媛, 鐘美容. 衰弱老年人生活質量的研究進展. 護士進修雜志, 2022, 37(11): 983-987.
3.	Dent E, Morley JE, Cruz-Jentoft AJ, et al. Physical frailty: ICFSR international clinical practice guidelines for identification and management. J Nutr Health Aging, 2019, 23(9): 771-787.
4.	中華醫學會老年醫學分會, 《中華老年醫學雜志》編輯委員會. 老年人衰弱預防中國專家共識(2022). 中華老年醫學雜志, 2022, 41(5): 503-511.
5.	蒲虹杉, 董碧蓉. 老年肌少癥與衰弱和營養. 中國臨床保健雜志, 2021, 24(5): 577-581.
6.	侯志濤. 老年人抗阻訓練健身方案制定和效果研究. 北京: 北京體育大學, 2015.
7.	Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging, 2012, 16(7): 601-608.
8.	中華醫學會老年醫學分會. 老年患者衰弱評估與干預中國專家共識. 中華老年醫學雜志, 2017, 36(3): 251-256.
9.	景冬梅, 沈沖, 莫永珍, 等. 中文版衰弱量表在老年衰弱評價中的信效度研究. 護士進修雜志, 2021, 36(9): 784-788.
10.	Guralnik JM, Winograd CH. Physical performance measures in the assessment of older persons. Aging (Milano), 1994, 6(5): 303-305.
11.	劉娟, 丁清清, 周白瑜, 等. 中國老年人肌少癥診療專家共識(2021). 中華老年醫學雜志, 2021, 40(8): 943-952.
12.	楊黎, 鄺小迪, 蘇愛華. 老年人失能及其測評工具的研究進展. 護理研究, 2019, 33(10): 1722-1726.
13.	Mathias S, Nayak US, Isaacs B. Balance in elderly patients: the “get-up and go” test. Arch Phys Med Rehabil, 1986, 67(6): 387-389.
14.	Iwase H, Murata S, Nakano H, et al. Relationship between age-related changes in skeletal muscle mass and physical function: a cross-sectional study of an elderly Japanese population. Cureus, 2022, 14(4): e24260.
15.	中國老年保健醫學研究會老齡健康服務與標準化分會, 《中國老年保健醫學》雜志編輯委員會. 中國老年人跌倒風險評估專家共識(草案). 中國老年保健醫學, 2019, 17(4): 47-48, 50.
16.	李燕, 黃麗華. 老年人平衡能力評估及干預的研究進展. 中華護理雜志, 2019, 54(4): 603-608.
17.	衛尹, 曹艷佩, 楊曉莉, 等. 老年住院患者衰弱綜合征現狀及影響因素. 復旦學報 (醫學版), 2018, 45(4): 496-502.
18.	賴小星, 霍曉鵬, 薄琳, 等. 高齡老年住院患者衰弱現狀及影響因素的研究. 北京醫學, 2021, 43(3): 198-202.
19.	田鵬, 楊寧, 郝秋奎, 等. 中國老年衰弱患病率的系統評價. 中國循證醫學雜志, 2019, 19(6): 657-664.
20.	Veronese N, Custodero C, Cella A, et al. Prevalence of multidimensional frailty and pre-frailty in older people in different settings: a systematic review and meta-analysis. Ageing Res Rev, 2021, 72: 101498.
21.	李曉凱, 陳長香, 張敏, 等. 唐山市中高齡老年人健康促進生活方式與衰弱的相關性. 中國老年學雜志, 2019, 39(15): 3783-3786.
22.	吳劍卿, 陳波, 毛擁軍, 等. 老年人軀體功能受損防控干預中國專家共識(2022). 中華老年醫學雜志, 2022, 41(10): 1137-1145.
23.	Cesari M, Landi F, Vellas B, et al. Sarcopenia and physical frailty: two sides of the same coin. Front Aging Neurosci, 2014, 6: 192.
24.	寧曉暄, 歐陽敏, Leng Sean X. 老年人衰弱綜合征的發病機制和評估及管理. 中華老年醫學雜志, 2015, 34(12): 1282-1285.
25.	Yao SS, Meng X, Cao GY, et al. Associations between multimorbidity and physical performance in older chinese adults. Int J Environ Res Public Health, 2020, 17(12): 4546.
26.	Wang DXM, Yao J, Zirek Y, et al. Muscle mass, strength, and physical performance predicting activities of daily living: a meta-analysis. J Cachexia Sarcopenia Muscle, 2020, 11(1): 3-25.
27.	Volpi E, Nazemi R, Fujita S. Muscle tissue changes with aging. Curr Opin Clin Nutr Metab Care, 2004, 7(4): 405-410.
28.	Corsonello A, Lattanzio F, Pedone C, et al. Prognostic significance of the short physical performance battery in older patients discharged from acute care hospitals. Rejuvenation Res, 2012, 15(1): 41-48.
29.	Fortes-Filho SQ, Aliberti MJR, Apolinario D, et al. Role of gait speed, strength, and balance in predicting adverse outcomes of acutely ill older outpatients. J Nutr Health Aging, 2020, 24(1): 113-118.
30.	高志鵬. 八段錦對衰弱前期老年人衰弱狀態及下肢運動功能的康復效果. 河北唐山: 華北理工大學, 2020.
31.	Jung HW, Baek JY, Jang IY, et al. Short physical performance battery as a crosswalk between frailty phenotype and deficit-accumulation frailty index. J Gerontol A Biol Sci Med Sci, 2021, 76(12): 2249-2255.
32.	李凌, 王玉梅, 張艷玲, 等. 老年病人衰弱綜合征與肌肉功能的相關性研究. 護理研究, 2019, 33(6): 917-920.
33.	馬昊哲, 趙良淵, 張曉紅. 中國老年人簡易機體功能評估結果及其影響因素分析. 護理研究, 2022, 36(14): 2491-2496.
34.	Bergland A, Strand BH. Norwegian reference values for the short physical performance battery (sppb): the troms? study. BMC Geriatr, 2019, 19(1): 216.
35.	Fyfe JJ, Hamilton DL, Daly RM. Minimal-dose resistance training for improving muscle mass, strength, and function: a narrative review of current evidence and practical considerations. Sports Med, 2022, 52(3): 463-479.
36.	Nayasista AH, Tinduh D, Alit Pawana IP, et al. Effect of combined locomotor training and aerobic exercise on increasing handgrip strength in elderly with locomotive syndrome: a randomised controlled trial. Ann Med Surg (Lond), 2022, 78: 103800.
37.	Sung JH, Son SR, Baek SH, et al. The association of aerobic, resistance, and combined exercises with the handgrip strength of middle-aged and elderly Korean adults: a nationwide cross-sectional study. BMC Geriatr, 2022, 22(1): 676.
38.	Puthucheary ZA, Rawal J, McPhail M, et al, et al. Acute skeletal muscle wasting in critical illness. JAMA, 2013, 310(15): 1591-1600.

1. Walston J, Bandeen-Roche K, Buta B, et al. Moving frailty toward clinical practice: NIA intramural frailty science symposium summary. J Am Geriatr Soc, 2019, 67(8): 1559-1564.
2. 黃小媛, 鐘美容. 衰弱老年人生活質量的研究進展. 護士進修雜志, 2022, 37(11): 983-987.
3. Dent E, Morley JE, Cruz-Jentoft AJ, et al. Physical frailty: ICFSR international clinical practice guidelines for identification and management. J Nutr Health Aging, 2019, 23(9): 771-787.
4. 中華醫學會老年醫學分會, 《中華老年醫學雜志》編輯委員會. 老年人衰弱預防中國專家共識(2022). 中華老年醫學雜志, 2022, 41(5): 503-511.
5. 蒲虹杉, 董碧蓉. 老年肌少癥與衰弱和營養. 中國臨床保健雜志, 2021, 24(5): 577-581.
6. 侯志濤. 老年人抗阻訓練健身方案制定和效果研究. 北京: 北京體育大學, 2015.
7. Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging, 2012, 16(7): 601-608.
8. 中華醫學會老年醫學分會. 老年患者衰弱評估與干預中國專家共識. 中華老年醫學雜志, 2017, 36(3): 251-256.
9. 景冬梅, 沈沖, 莫永珍, 等. 中文版衰弱量表在老年衰弱評價中的信效度研究. 護士進修雜志, 2021, 36(9): 784-788.
10. Guralnik JM, Winograd CH. Physical performance measures in the assessment of older persons. Aging (Milano), 1994, 6(5): 303-305.
11. 劉娟, 丁清清, 周白瑜, 等. 中國老年人肌少癥診療專家共識(2021). 中華老年醫學雜志, 2021, 40(8): 943-952.
12. 楊黎, 鄺小迪, 蘇愛華. 老年人失能及其測評工具的研究進展. 護理研究, 2019, 33(10): 1722-1726.
13. Mathias S, Nayak US, Isaacs B. Balance in elderly patients: the “get-up and go” test. Arch Phys Med Rehabil, 1986, 67(6): 387-389.
14. Iwase H, Murata S, Nakano H, et al. Relationship between age-related changes in skeletal muscle mass and physical function: a cross-sectional study of an elderly Japanese population. Cureus, 2022, 14(4): e24260.
15. 中國老年保健醫學研究會老齡健康服務與標準化分會, 《中國老年保健醫學》雜志編輯委員會. 中國老年人跌倒風險評估專家共識(草案). 中國老年保健醫學, 2019, 17(4): 47-48, 50.
16. 李燕, 黃麗華. 老年人平衡能力評估及干預的研究進展. 中華護理雜志, 2019, 54(4): 603-608.
17. 衛尹, 曹艷佩, 楊曉莉, 等. 老年住院患者衰弱綜合征現狀及影響因素. 復旦學報 (醫學版), 2018, 45(4): 496-502.
18. 賴小星, 霍曉鵬, 薄琳, 等. 高齡老年住院患者衰弱現狀及影響因素的研究. 北京醫學, 2021, 43(3): 198-202.
19. 田鵬, 楊寧, 郝秋奎, 等. 中國老年衰弱患病率的系統評價. 中國循證醫學雜志, 2019, 19(6): 657-664.
20. Veronese N, Custodero C, Cella A, et al. Prevalence of multidimensional frailty and pre-frailty in older people in different settings: a systematic review and meta-analysis. Ageing Res Rev, 2021, 72: 101498.
21. 李曉凱, 陳長香, 張敏, 等. 唐山市中高齡老年人健康促進生活方式與衰弱的相關性. 中國老年學雜志, 2019, 39(15): 3783-3786.
22. 吳劍卿, 陳波, 毛擁軍, 等. 老年人軀體功能受損防控干預中國專家共識(2022). 中華老年醫學雜志, 2022, 41(10): 1137-1145.
23. Cesari M, Landi F, Vellas B, et al. Sarcopenia and physical frailty: two sides of the same coin. Front Aging Neurosci, 2014, 6: 192.
24. 寧曉暄, 歐陽敏, Leng Sean X. 老年人衰弱綜合征的發病機制和評估及管理. 中華老年醫學雜志, 2015, 34(12): 1282-1285.
25. Yao SS, Meng X, Cao GY, et al. Associations between multimorbidity and physical performance in older chinese adults. Int J Environ Res Public Health, 2020, 17(12): 4546.
26. Wang DXM, Yao J, Zirek Y, et al. Muscle mass, strength, and physical performance predicting activities of daily living: a meta-analysis. J Cachexia Sarcopenia Muscle, 2020, 11(1): 3-25.
27. Volpi E, Nazemi R, Fujita S. Muscle tissue changes with aging. Curr Opin Clin Nutr Metab Care, 2004, 7(4): 405-410.
28. Corsonello A, Lattanzio F, Pedone C, et al. Prognostic significance of the short physical performance battery in older patients discharged from acute care hospitals. Rejuvenation Res, 2012, 15(1): 41-48.
29. Fortes-Filho SQ, Aliberti MJR, Apolinario D, et al. Role of gait speed, strength, and balance in predicting adverse outcomes of acutely ill older outpatients. J Nutr Health Aging, 2020, 24(1): 113-118.
30. 高志鵬. 八段錦對衰弱前期老年人衰弱狀態及下肢運動功能的康復效果. 河北唐山: 華北理工大學, 2020.
31. Jung HW, Baek JY, Jang IY, et al. Short physical performance battery as a crosswalk between frailty phenotype and deficit-accumulation frailty index. J Gerontol A Biol Sci Med Sci, 2021, 76(12): 2249-2255.
32. 李凌, 王玉梅, 張艷玲, 等. 老年病人衰弱綜合征與肌肉功能的相關性研究. 護理研究, 2019, 33(6): 917-920.
33. 馬昊哲, 趙良淵, 張曉紅. 中國老年人簡易機體功能評估結果及其影響因素分析. 護理研究, 2022, 36(14): 2491-2496.
34. Bergland A, Strand BH. Norwegian reference values for the short physical performance battery (sppb): the troms? study. BMC Geriatr, 2019, 19(1): 216.
35. Fyfe JJ, Hamilton DL, Daly RM. Minimal-dose resistance training for improving muscle mass, strength, and function: a narrative review of current evidence and practical considerations. Sports Med, 2022, 52(3): 463-479.
36. Nayasista AH, Tinduh D, Alit Pawana IP, et al. Effect of combined locomotor training and aerobic exercise on increasing handgrip strength in elderly with locomotive syndrome: a randomised controlled trial. Ann Med Surg (Lond), 2022, 78: 103800.
37. Sung JH, Son SR, Baek SH, et al. The association of aerobic, resistance, and combined exercises with the handgrip strength of middle-aged and elderly Korean adults: a nationwide cross-sectional study. BMC Geriatr, 2022, 22(1): 676.
38. Puthucheary ZA, Rawal J, McPhail M, et al, et al. Acute skeletal muscle wasting in critical illness. JAMA, 2013, 310(15): 1591-1600.

West China Medical Journal

Correlation analysis of frailty syndrome and lower limb motor function in hospitalized elderly patients

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