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中华危重症医学杂志(电子版) ›› 2022, Vol. 15 ›› Issue (02) : 89 -97. doi: 10.3877/cma.j.issn.1674-6880.2022.02.001

所属专题: 指南共识

标准与指南

老年人衰弱预防中国专家共识(2022)
中华医学会老年医学分会, 《中华老年医学杂志》编辑委员会   
  1. 1. 浙江大学医学院附属第一医院老年医学科
    2. 海军军医大学第一附属医院老年医学科
    3. 北京医院 国家老年医学中心 中国医学科学院老年医学研究院
  • 收稿日期:2021-12-02 出版日期:2022-04-30

Chinese expert consensus on prevention of frailty in the elderly (2022)

Chinese Geriatrics Society, Editorial Board, of Chinese Journal of Geriatrics   

  • Received:2021-12-02 Published:2022-04-30
引用本文:

中华医学会老年医学分会, 《中华老年医学杂志》编辑委员会. 老年人衰弱预防中国专家共识(2022)[J]. 中华危重症医学杂志(电子版), 2022, 15(02): 89-97.

Chinese Geriatrics Society, Editorial Board, of Chinese Journal of Geriatrics. Chinese expert consensus on prevention of frailty in the elderly (2022)[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2022, 15(02): 89-97.

表1 快速综合评估流程
评估量表 评估内容 得分
FRAIL衰弱 1.过去四周大部分时间或所有时间感到疲乏 是:1分,否:0分
量表 2.在不用任何辅助工具及不用他人帮助的情况下,中途不休息爬一层楼梯有困难 是:1分,否:0分
  3.在不用任何辅助工具及不用他人帮助的情况下,走完100 m较困难 是:1分,否:0分
  4.医生曾告诉您存在5种以上如下疾病:高血压、糖尿病、急性心脏疾病发作、卒中、恶性肿瘤(微小皮肤癌除外)、充血性心力衰竭、哮喘、关节炎、慢性肺病、肾脏疾病、心绞痛等 是:1分,否:0分
  5.1年或更短时间内出现体质量下降≥ 5% 是:1分,否:0分
营养评价问卷简表 1.食欲状况:A.非常差;B.差;C.一般;D.好;E.非常好 A = 1分;B = 2分;C = 3分;D = 4分;E = 5分
  2.进食中什么时候觉得有饱感:A.只吃几口就觉得饱了;B.吃到餐食的1/3时觉得饱了;C.吃到餐食的一半时觉得饱了;D.基本吃光餐食时觉得饱了;E.很少觉得有饱感 A = 1分;B = 2分;C = 3分;D = 4分;E = 5分
  3.对食物的味觉A.非常差;B.差;C.一般;D.好;E.非常好 A = 1分;B = 2分;C = 3分;D = 4分;E = 5分
  4.正常的进餐数量A.每日少于1餐;B.每日1餐;C.每日2餐;D.每日3餐;E.每日大于3餐 A = 1分;B = 2分;C = 3分;D = 4分;E = 5分
肌少症筛查量表 1.力量:举起或搬运约4.5 kg的物体是否存在困难 0分:没有困难;1分:稍有困难;2分:困难较大或不能完成
  2.辅助行走:步行穿过房间是否存在困难,是否需要帮助 0分:没有困难;1分:稍有困难;2分:困难较大或不能完成
  3.起立:从椅子或者床起立是否存在困难,是否需要帮助 0分:没有困难;1分:稍有困难;2分:困难较大或不能完成
  4.爬楼梯:爬10层台阶是否存在困难 0分:没有困难;1分:稍有困难;2分:困难较大或不能完成
  5.跌倒:过去1年的跌倒情况 0分:无跌倒史;1分:跌倒1~3次;2分:跌倒4次以上
简易认知状态评估量表 请仔细听并记住以下5个单词,稍后我将请您重复:苹果、钢笔、领带、房子、汽车请您在一张空白纸上画出钟的外形,标号时钟数,并在钟上标记时间为:11 ∶ 10 能正确标明时钟数字位置:2分;能正确显示所给定的时间:2分
  请您说出先前的5个单词 每回忆出1个单词:1分
  我现在要讲一个故事,请专心听,等一下我会问您一些关于这个故事的问题。梅梅是一个非常成功的保险业务员,她在工作中赚了很多钱。她认识了李雷,一个大帅哥。两人结婚后生了3个孩子,他们一家人住在北京,她辞了工作在家专心带小孩。当孩子长大了,她又回到职场上重新开始工作。她和李雷从此快乐地生活在一起。提问:她住在哪里? 能正确回答住在北京:1分
1
党俊武. 老龄蓝皮书: 中国城乡老年人生活状况调查报告[M]. 北京: 社会科学文献出版社, 2018.
2
黄改荣, 刘祥. 老年人衰弱与失能[J]. 中华老年医学杂志, 2019, 38 (10) : 1085-1087.
3
老龄健康司. 老年失能预防核心信息[M]. 中华人民共和国国家卫生健康委办公厅, 2019.
4
孟丽, 李鹏, 施红, 等. 老年人衰弱表型干预效果分析[J]. 中华老年医学杂志, 2019, 38 (7) : 810-815.
5
MaL, TangZ, ZhangL,et al.Prevalence of frailty and associated factors in the community-dwelling population of China[J].J Am Geriatr Soc,2018,66 (3):559-564.
6
HeB, MaY, WangC,et al.Prevalence and risk factors for frailty among community-dwelling older people in China: a systematic review and meta-analysis[J].J Nutr Health Aging,2019,23 (5):442-450.
7
WuC, SmitE, XueQL,et al.Prevalence and cor-relates of frailty among community-dwelling chinese older adults: the China health and retirement longitudinal study[J].J Gerontol A Biol Sci Med Sci,2017,73 (1):102-108.
8
LiangYD, ZhangYN, LiYM,et al.Identification of frailty and its risk factors in elderly hospitalized patients from different wards: a cross-sectional study in China[J].Clin Interv Aging,2019 (14):2249-2259.
9
马丽娜, 陈彪. 老年人衰弱综合征的研究现状及发展趋势[J]. 中华老年医学杂志, 2020, 39 (4) : 369-372.
10
DentE, MorleyJE, Cruz-JentoftAJ,et al.Physical frailty: ICFSR international clinical practice guidelines for identification and management[J].J Nutr Health Aging,2019,23 (9):771-787.
11
FriedLP, TangenCM, WalstonJ,et al.Frailty in older adults: evidence for a phenotype[J].J Gerontol A Biol Sci Med Sci,2001,56 (3):146-156.
12
潘一鸣, 李耘, 马丽娜. 老年人衰弱综合征组学相关生物学标记物的研究进展[J].中华老年医学杂志, 2021, 40 (9) : 1189-1193.
13
ConteM, OstanR, FabbriC,et al.Human aging and longevity are characterized by high levels of mitokines[J].J Gerontol A Biol Sci Med Sci,2019,74 (5):600-607.
14
PalmerJ, PanditV, ZeeshanM,et al.The acute inflammatory response after trauma is heightened by frailty: a prospective evaluation of inflammatory and endocrine system alterations in frailty[J].J Trauma Acute Care Surg,2019,87 (1):54-60.
15
KaneAE, SinclairDA.Frailty biomarkers in humans and rodents: current approaches and future advances[J].Mech Ageing Dev,2019 (180):117-128.
16
KojimaG, IliffeS, TaniguchiY,et al.Prevalence of frailty in Japan: a systematic review and meta-analysis[J].J Epidemiol,2017,27 (8):347-353.
17
高杰, 张晓, 魏超. 不同性别的高龄老年人衰弱的差异研究[J]. 中华老年医学杂志, 2020, 39 (11) : 1335-1339.
18
JarachCM, TettamantiM, NobiliA,et al.Social isolation and loneliness as related to progression and reversion of frailty in the survey of health aging retirement in Europe (share)[J].Age Ageing,2021,50 (1):258-262.
19
SirvenN, DumontetM, RappT.The dynamics of frailty and change in socio-economic conditions: evidence for the 65+ in Europe[J].Eur J Public Health,2020,30 (4):715-719.
20
GaleCR, WestburyL, CooperC.Social isolation and loneliness as risk factors for the progression of frailty: the English longitudinal study of ageing[J].Age Ageing,2018,47 (3):392-397.
21
GomesCDS, GuerraRO, WuYY,et al.Social and economic predictors of worse frailty status occurrence across selected countries in North and South America and Europe[J].Innov Aging,2018,2 (3):igy037.
22
TheouO, BrothersTD, RockwoodMR,et al.Exploring the relationship between national economic indicators and relative fitness and frailty in middle-aged and older Europeans[J].Age Ageing,2013,42 (5):614-619.
23
KwanRYC, LeungAYM, YeeA,et al.Cognitive frailty and its association with nutrition and depression in community-dwelling older people[J].J Nutr Health Aging,2019,23 (10):943-948.
24
MaL, SunF, TangZ.Social frailty is associated with physical functioning, cognition, and depression, and predicts mortality[J].J Nutr Health Aging,2018,22 (8):989-995.
25
BrownPJ, RooseSP, O'BoyleKR,et al.Frailty and its correlates in adults with late life depression[J].Am J Geriatr Psychiatry,2020,28 (2):145-154.
26
LeighJP, FriesJF.Frailty and education in the hispanic health and nutrition examination survey[J].J Health Care Poor Underserved,2002,13 (1):112-127.
27
HuibregtseBM, Newell-StamperBL, DomingueBW,et al.Genes related to education predict frailty among older adults in the United States[J].J Gerontol B Psychol Sci Soc Sci,2021,76 (1):173-183.
28
TorresJL, da SilvaSLA, LustosaLP.The role of education on the association between disability and depressive symptoms among community-dwelling older adults: evidence from frailty in Brazilian older people (fibra) study[J].Arch Gerontol Geriatr,2019 (80):120-124.
29
MlynarskaA, MlynarskiR, GolbaKS.Anxiety, age, education and activities of daily living as predictive factors of the occurrence of frailty syndrome in patients with heart rhythm disorders[J].Aging Ment Health,2018,22 (9):1179-1183.
30
AmiriS, BehnezhadS.Systematic review and meta-analysis of the association between smoking and the incidence of frailty[J].Neuropsychiatr,2019,33 (4):198-206.
31
ShinJ, KimKJ, ChoiJ.Smoking, alcohol intake, and frailty in older Korean adult men: cross-sectional study with nationwide data[J].Eur Geriatr Med,2020,11 (2):269-277.
32
MaffeiVJ, FergusonTF, BrashearMM,et al.Lifetime alcohol use among persons living with HIV is associated with frailty[J].AIDS,2020,34 (2):245-254.
33
SchoufourJD, OverdevestE, WeijsPJM,et al.Dietary protein, exercise, and frailty domains[J].Nutrients,2019,11 (10):2399.
34
DamlujiAA, ChungSE, XueQL,et al.Physical frailty phenotype and the development of geriatric syndromes in older adults with coronary heart disease[J].Am J Med,2021,134 (5):662-671.e1.
35
SoysalP, ArikF, SmithL,et al.Inflammation, frailty and cardiovascular disease[J].Adv Exp Med Biol,2020 (1216):55-64.
36
StewartR.Cardiovascular disease and frailty: what are the mechanistic links?[J].Clin Chem,2019,65 (1):80-86.
37
LiuP, LiY, ZhangY,et al.Frailty and hypertension in older adults: current understanding and future perspectives[J].Hypertens Res,2020,43 (12):1352-1360.
38
Gómez-GómezME, ZapicoSC.Frailty, cognitive decline, neurodegenerative diseases and nutrition interventions[J].Int J Mol Sci,2019,20 (11):2842.
39
WaiteSJ, MaitlandS, ThomasA,et al.Sarcopenia and frailty in individuals with dementia: a systematic review[J].Arch Gerontol Geriatr,2021 (92):104268.
40
NtanasiE, MarakiM, YannakouliaM,et al.Frailty and prodromal Parkinson's disease: results from the heliad study[J].J Gerontol A Biol Sci Med Sci,2021,76 (4):622-629.
41
FabrícioDM, ChagasMHN, DinizBS.Frailty and cognitive decline[J].Transl Res,2020 (221):58-64.
42
DiasLS, FerreiraACG, da Silva JuniorJLR,et al.Prevalence of frailty and evaluation of associated variables among COPD patients[J].Int J Chron Obstruct Pulmon Dis,2020 (15):1349-1356.
43
GrecoEA, PietschmannP, MigliaccioS.Osteoporosis and sarcopenia increase frailty syndrome in the elderly[J].Front Endocrinol (Lausanne),2019 (10):255.
44
LeeHJ, SonYJ.Prevalence and associated factors of frailty and mortality in patients with end-stage renal disease undergoing hemodialysis: a systematic review and meta-analysis[J].Int J Environ Res Public Health,2021,18 (7):3471.
45
Zugasti MurilloA,Casas Herrero a. Frailty syndrome and nutritional status: assessment, prevention and treatment[J].Nutr Hosp,2019 (36):26-37.
46
ShmuelS, LundJL, AlvarezC,et al.Polypharmacy and incident frailty in a longitudinal community-based cohort study[J].J Am Geriatr Soc,2019,67 (12):2482-2489.
47
KawadaT.Antipsychotic drugs, fracture risk, and frailty in older patients[J].J Am Med Dir Assoc,2020,21 (4):565.
48
RuizSJ, CevallosV, BaskaranD,et al.The cross-sectional association of frailty with past and current exposure to strong anticholinergic drugs[J].Aging Clin Exp Res,2021,33 (8):2283-2289.
49
KannoT, MoayyediP.Proton pump inhibitors in the elderly, balancing risk and benefit: an age-old problem[J].Curr Gastroenterol Rep,2019,21 (12):65.
50
高会莹, 程秀丽, 江美娜, 等. 老年住院患者抑郁症状与衰弱状况关系的研究[J]. 中华老年医学杂志, 2019, 38 (6) : 631-634.
51
PourmotabbedA, BoozariB, BabaeiA,et al.Sleep and frailty risk: a systematic review and meta-analysis[J].Sleep Breath,2020,24 (3):1187-1197.
52
ZhaoW, ZhangY, LiuX,et al.Comorbid depressive and anxiety symptoms and frailty among older adults: findings from the west China health and aging trend study[J].J Affect Disord,2020 (277):970-976.
53
WindhaberT, KoulaML, NtzaniE,et al.Educational strategies to train health care professionals across the education continuum on the process of frailty prevention and frailty management: a systematic review[J].Aging Clin Exp Res,2018,30 (12):1409-1415.
54
WalstonJ, ButaB, XueQL.Frailty screening and interventions: considerations for clinical practice[J].Clin Geriatr Med,2018,34 (1):25-38.
55
MerchantRA, HuiRJY, KwekSC,et al.Rapid geriatric assessment using mobile app in primary care: prevalence of geriatric syndromes and review of its feasibility[J].Front Med (Lausanne),2020 (7):261.
56
RuizJG, DentE, MorleyJE,et al.Screening for and managing the person with frailty in primary care: ICFSR consensus guidelines[J].J Nutr Health Aging,2020,24 (9):920-927.
57
VolkertD, BeckAM, CederholmT,et al.Espen guideline on clinical nutrition and hydration in geriatrics[J].Clin Nutr,2019,38 (1):10-47.
58
中华医学会老年医学分会. 老年医学(病)科临床营养管理指导意见[J]. 中华老年医学杂志, 2015, 34 (12) : 1388-1395.
59
中华医学会肠外肠内营养学分会老年营养支持学组. 中国老年患者肠外肠内营养应用指南(2020) [J]. 中华老年医学杂志, 2020, 39 (2) : 119-132.
60
中华医学会老年医学分会, 《中华老年医学杂志》编辑委员会. 肠道微生态制剂老年人临床应用中国专家共识(2019) [J]. 中华老年医学杂志, 2019, 38 (4) : 355-361.
61
中国营养学会老年营养分会.肌肉衰减综合征营养与运动干预中国专家共识[J]. 营养学报, 2015 (4) : 320-324.
62
WardwellL, Chapman-NovakofskiK, HerrelS,et al.Nutrient intake and immune function of elderly subjects[J].J Am Diet Assoc,2008,108 (12):2005-2012.
63
严悦, 张艺雄. 运动干预在老年衰弱人群中的研究现状[J]. 中华老年医学杂志, 2021, 40 (6) : 807-811.
64
IzquierdoM, MerchantRA, MorleyJE,et al.International exercise recommendations in older adults (ICFSR): expert consensus guidelines[J].J Nutr Health Aging,2021,25 (7):824-853.
65
FragalaMS, CadoreEL, DorgoS,et al.Resistance training for older adults: position statement from the national strength and conditioning association[J].J Strength Cond Res,2019,33 (8):2019-2052.
66
LeePG, JacksonEA, RichardsonCR.Exercise prescriptions in older adults[J].Am Fam Physician,2017,95 (7):425-432.
67
中华医学会老年医学分会. 老年患者6分钟步行试验临床应用中国专家共识[J]. 中华老年医学杂志, 2020, 39 (11) : 1241-1250.
68
WhileAE.Falls and older people: understanding why people fall[J].Br J Community Nurs,2020,25 (4):173-177.
69
周双, 张晓琳, 吴松涛, 等. 衰弱老年人合理用药处方筛查工具的介绍及解读[J]. 中华老年医学杂志, 2019, 38 (7) : 713-716.
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