论文标题：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

发表时间：2019/12/04

数字识别码：10.1186/s12877-019-1342-5

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中国的老年人口在迅速增长，人均预期寿命已从1950年的44.6岁增加到2015年的75.3岁，到2050年会接近80岁。随着人口的老龄化，社会的总体疾病负担开始转化成以慢性非传染性疾病为主。贫血和虚弱是导致老年人健康恶化的因素。贫血定义为男性的血红蛋白低于每分升13克，女性低于每分升12克。贫血的症状包括疲劳感增强，认知能力降低，肌肉力量减弱等，这些因素也使老年人更加虚弱。

然而，目前在低收入国家中进行的研究大多只关注贫血或虚弱，而缺乏对两者的综合考虑。发表在BMC Geriatrics的Association between anemia and frailty in 13,175 community-dwelling adults aged 50 years and older in China 旨在评估世界卫生组织《全球老龄化与成人健康研究》中国项目第一轮调查里研究过的13175名50岁及50岁以上社区居民群里贫血与虚弱的关系。研究人员定义虚弱指数（FI）评估参与者的虚弱程度，并用 2级分层逻辑模型评估贫血和虚弱之间的关联。

图1

本研究发现贫血和低血红蛋白浓度与虚弱有明显的关联。参与者贫血患病率为31.0％（95％置信区间：28.4，33.8％），虚弱的患病率为14.7％（95％置信区间：13.5，16.0％）。在单变量回归模型中，贫血与虚弱有明显的关联（比值比 = 1.62，95％置信区间：1.39，1.90）。在调整了各种可能的干扰因素，包括年龄、性别、住址、教育程度、家庭经济情况、水果和蔬菜的摄入量、烟草和酒精的使用以及运动量以后，该结论仍然保持一致 （调整后的比值比为1.31，95％置信区间：1.09，1.57）。参与者的血红蛋白浓度每增加每分升1克，其患虚弱几率就会降低4％（调整后的比值比为0.96，95％置信区间：0.93，0.99）。因此，照顾老年人的医疗保健专业人员应增加对贫血患者的筛查、评估及治疗以此避免、延缓甚至扭转虚弱的。

贫血和虚弱在老人群内并存的现象对全球的医疗系统带来了潜在的挑战。最近的一项荟萃分析估计，有贫血的老年人也患有虚弱的几率比一般老人要高出一倍以上，该篇文章是首次在中国开展的有代表性的研究来评估贫血与虚弱在中国社区的老年人群内的关系。

注解：Rockwood的虚弱指数（FI）是30-40个临床变量的缺陷的积累。Fried建议通过五种症状（无意识的体重减轻，虚弱，耐力和精力不佳，缓慢和低运动量）中的至少三种来识别脆弱的表型。根据不同的评估方法和地理区域，虚弱的患病率从4％到59.1％不等。

图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.

（来源：科学网）