南京市≥60岁社区老年人疲劳与衰弱的关联性研究

doi:10.3969/j.issn.1003-9198.2026.08.017

摘要/Abstract

摘要： 目的了解南京市社区居住老年人群衰弱的流行水平,并探讨疲劳与衰弱的关联。方法采用2023年南京市社区老年人调查数据,基于多阶段分层抽样纳入≥60岁老年人5484名。疲劳采用匹兹堡疲劳量表(PFS)评估,以PFS≥15分判定为疲劳;衰弱采用格罗宁根衰弱指标(GFI)评估,以GFI≥3分判定为衰弱。采用以社区为随机截距的混合效应logistic回归模型,分析疲劳与衰弱的关联;鉴于入选对象衰弱的患病率较高(24.9%),进一步采用以社区为聚类单位的广义估计方程(generalized estimating equation,GEE)稳健Poisson回归分析PFS得分(连续变量)与衰弱患病的关联,报告患病率比(prevalence ratio,PR)及其95%CI,并换算每增加5分、10分的效应量。结果研究对象衰弱患病率为24.9%(95%CI:23.8%～26.1%)。混合效应logistic回归显示:未调整模型中疲劳与衰弱患病呈显著正向关联(OR=2.04,95%CI:1.78～2.35,P<0.001);进一步调整社会人口学特征、生活方式、慢病、睡眠质量及焦虑/抑郁等混杂因素后,疲劳与衰弱患病仍保持正向关联(OR=1.61,95%CI:1.38～1.86,P<0.001);分层分析显示,该关联在不同性别及年龄组中均存在。GEE稳健Poisson回归提示,PFS得分与衰弱患病呈分值递增的线性趋势:调整后每增加1分PR=1.02(95%CI:1.01～1.03,P<0.001),每增加5分PR=1.11(95%CI:1.06～1.16,P<0.001),每增加10分PR=1.23(95%CI:1.12～1.36,P<0.001)。结论南京市社区老年人衰弱患病率较高;疲劳与衰弱患病存在稳定的正向关联,且疲劳得分升高与衰弱患病率增加呈分值递增的线性趋势。

关键词: 老年人, 衰弱, 疲劳, 社区人群

Abstract: Objective To investigate the prevalence of frailty among community-dwelling older adults in Nanjing and to examine the association between fatigue and frailty. Methods Based on data from the 2023 survey of community-dwelling older adults in Nanjing, a total of 5484 older adults aged ≥60 years were enrolled through multistage stratified sampling. Fatigue was assessed using the Pittsburgh Fatigability Scale (PFS), with a total score ≥15 indicating fatigue. Frailty was assessed using the Groningen Frailty Indicator (GFI), with a total score ≥3 indicating frailty. A mixed-effects logistic regression model with community as a random intercept was used to analyze the association between fatigue and frailty. Given the relatively high prevalence of frailty (24.9%), robust Poisson regression based on generalized estimating equations (GEE), with community as the clustering unit, was further used to examine the association between continuous PFS scores and frailty prevalence, and prevalence ratios (PRs) with 95%CI were reported. Effect estimates were also converted for every 5-point and 10-point increase in PFS score. Results The prevalence of frailty was 24.9% (95%CI:23.8%-26.1%). Mixed-effects logistic regression showed that fatigue was significantly positively associated with frailty in the unadjusted model (OR=2.04, 95%CI:1.78-2.35, P<0.001). After further adjustment for sociodemographic characteristics, lifestyle factors, chronic diseases, sleep quality, and anxiety/depression, the positive association remained significant (OR=1.61, 95%CI:1.38-1.86, P<0.001). Stratified analysis showed that this association was present across gender and age groups. Robust Poisson regression using GEE indicated a linear dose-response relationship between PFS scores and frailty prevalence: after adjustment, each 1-point increase in PFS score was associated with a PR of 1.02 (95%CI:1.01-1.03, P<0.001), each 5-point increase with a PR of 1.11 (95%CI:1.06-1.16, P<0.001), and each 10-point increase with a PR of 1.23 (95%CI:1.12-1.36, P<0.001). Conclusions Frailty is relatively prevalent among community-dwelling older adults in Nanjing. Fatigue is stably and positively associated with frailty, and higher fatigue score is linearly associated with a higher prevalence of frailty.

Key words: older adults, frailty, fatigue, community population

中图分类号:

R 181.37

杨路延, 叶青, 王志勇, 胡彩红, 许慧清, 敖国凤, 徐斐. 南京市≥60岁社区老年人疲劳与衰弱的关联性研究[J]. 实用老年医学, 2026, 40(8): 843-849.

YANG Luyan, YE Qing, WANG Zhiyong, HU Caihong, XU Huiqing, AO Guofeng, XU Fei. Association between fatigue and frailty among community-dwelling older people aged ≥60 years old in Nanjing[J]. Practical Geriatrics, 2026, 40(8): 843-849.

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