Characterizing Frailty in Older Adults with Sickle Cell Disease Using a Sickle Cell Frailty Index (FI-SCD)

使用镰状细胞衰弱指数 (FI-SCD) 描述患有镰状细胞病的老年人的衰弱特征

• 批准号: 10302376
• 负责人: CHARITY IBILOLA OYEDEJI
• 金额: $ 16.1万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10302376
• 关键词: Activities of Daily Living; Address; Adult; Age; Aging; American; Anemia; Biomedical Research; Body Weight decreased; Caring; Cessation of life; Chronology; Clinical; Clinical Investigator; Computerized Medical Record; Coupled; Cross-Sectional Studies; Data; Dependence; Deterioration; Development; Elderly; Enrollment; Failure; Gait speed; Genotype; Geriatric Assessment; Geriatrics; Goals; Health; Health Status; Hemolysis; Hospitalization; Impaired cognition; Impairment; Individual; Intervention; Knowledge; Laboratories; Lead; Life Cycle Stages; Life Expectancy; Literature; Measures; Mentorship; Methods; Mission; Modification; National Institute on Aging; Organ; Pain; Pain intensity; Pain interference; Participant; Patients; Personal Satisfaction; Phenotype; Physical activity; Physiological; Pilot Projects; Population; Pulmonary Heart Disease; ROC Curve; Research; Research Personnel; Risk; Risk Factors; Sampling; Sensitivity and Specificity; Sensory; Sickle Cell; Sickle Cell Anemia; Sum; Syndrome; Training Programs; Work; adverse outcome; aging population; base; body system; career; cohort; comorbidity; disability; disability risk; exercise training; exhaustion; experience; frailty; functional decline; high risk; improved; improved functioning; indexing; low socioeconomic status; mortality; mortality risk; multidisciplinary; population stratification; premature; preservation; prevent; prospective; risk stratification; socioeconomics; stressor; success

Individuals with sickle cell disease (SCD) are living longer than ever before. As the number of older adults living with SCD grows, there is a greater need for data to determine the appropriate care for this population. As individuals with SCD age, they demonstrate substantial and early deterioration of multiple organ systems, which causes complications often seen in geriatric populations, such as cardiopulmonary disease, sensory impairment, functional decline, and cognitive impairment. Failure to recognize vulnerabilities and functional decline can lead to disability, dependence in activities of daily living, and premature death. Frailty is a syndrome characterized by decreased physiologic reserve and increased vulnerability to stressors that lead to adverse outcomes. Individuals with SCD experience a variety of stressors, such as hospitalizations for vasooclussive pain crises and organ damage; however, frailty has never been defined in people with SCD. The long-term objective of this research is to understand frailty, accelerated aging, functional decline in older adults with SCD and develop interventions to ameliorate these issues. The purpose of this study is to characterize frailty in older adults with SCD using a laboratory-based Sickle Cell Disease Frailty Index (FI-SCD) and a validated measure of frailty, the Fried Frailty Phenotype (FP). To achieve these goals, the investigators will determine the relationship between FI-SCD and FP in a single-center cross-sectional study of 100 older adults with SCD (defined as age 40 and older). For the first aim, the investigators developed a frailty index using routine laboratory variables associated with chronological aging and mortality in SCD and geriatrics. A frailty index score will be calculated by taking the sum of heath deficits and dividing that by the total number of variables evaluated. The investigators will compare the FI-SCD to FP, using correlation coefficient and ROC curves to describe sensitivity and specificity of FI-SCD for FP. For the second aim, investigators will identify factors associated with frailty in older adults with SCD by comparing frailty scores to PROMIS Pain Intensity, PROMIS Pain Interference, SCD genotype, SCD-complications, and non-SCD comorbidities. Factors associated with FI-SCD and FP will be identified using canonical correlation. Developing a frailty index for older adults with SCD will provide a method for early risk stratification of this population and will create a framework for developing interventions to prevent frailty, improve function, and reduce mortality. This research is consistent with the National Institute of Aging’s mission of improving the health and well-being of older Americans through biomedical research.

镰状细胞病 (SCD) 患者的寿命比以往任何时候都长。 患有 SCD 的老年人随着年龄的增长，更需要数据来确定适当的治疗方案 随着 SCD 患者年龄的增长，他们表现出大量且早期的护理。 多器官系统恶化，导致老年人常见的并发症 人群，如心肺疾病、感觉障碍、功能衰退等 未能认识到脆弱性和功能下降可能会导致认知障碍。 残疾、日常生活活动依赖和过早死亡是一种综合症。 其特点是生理储备减少和对压力源的脆弱性增加，导致 患有 SCD 的人会经历各种压力源，例如 因血管闭塞性疼痛危象和器官损伤而住院治疗，但从未出现过虚弱症状； 这项研究的长期目标是了解脆弱性， 患有 SCD 的老年人加速衰老、功能衰退，并制定干预措施 改善这些问题本研究的目的是描述老年人的虚弱特征。 SCD 使用基于实验室的镰状细胞病虚弱指数 (FI-SCD) 和经过验证的 为了实现这些目标，研究人员采用了弗里德衰弱表型（FP）来衡量衰弱程度。 将在单中心横断面研究中确定 FI-SCD 和 FP 之间的关系 调查人员对 100 名患有 SCD 的老年人（定义为 40 岁及以上）进行了调查。 使用与时间老化相关的常规实验室变量开发了衰弱指数 以及 SCD 和老年病学中的死亡率。将通过求和来计算衰弱指数评分。 健康缺陷并将其除以评估的变量总数。 将 FI-SCD 与 FP 进行比较，使用相关系数和 ROC 曲线来描述灵敏度 对于第二个目标，研究人员将确定相关因素。 通过将虚弱评分与 PROMIS 疼痛强度进行比较，了解患有 SCD 的老年人的虚弱情况， PROMIS 疼痛干扰、SCD 基因型、SCD 并发症和非 SCD 合并症。 与 FI-SCD 和 FP 相关的因素将使用典型相关性来确定。 患有 SCD 的老年人的虚弱指数将提供一种早期风险分层的方法 人口，并将建立一个框架来制定干预措施，以防止虚弱、改善 这项研究与国家老龄化研究所的研究结果一致。 通过生物医学研究改善美国老年人的健康和福祉的使命。