Testing the Validity of a Construct of Geriatric Frailty

测试老年衰弱结构的有效性

• 批准号: 7388857
• 负责人: CATHERINE A SARKISIAN
• 金额: $ 18.62万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-04-01 至 2011-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7388857
• 关键词: Address; Adult; Age; Aging; Anorexia; Behavioral; Biology; Body Weight decreased; Cardiovascular system; Characteristics; Clinical; Cognitive; Cohort Studies; Comorbidity; Complex; Condition; Data; Data Set; Depth; Development; Elderly; Equation; Functional disorder; Gait; Geriatrics; Health; Hospitalization; Impaired cognition; Inflammation; Inflammatory; Institutes; Intervention; Investigation; Knowledge; Lead; Light; Link; Literature; Measures; Medical; Mental disorders; Modeling; Morbidity - disease rate; Muscle; Neurosecretory Systems; Numbers; Outcome; Paper; Pattern; Phenotype; Physical activity; Physiological; Process; Publishing; Range; Research; Research Personnel; Research Project Grants; Resistance; Risk; Role; Sampling; Self Efficacy; Serum Markers; Social support; Syndrome; System; Techniques; Testing; Urine; Work; allostatic load; cognitive function; concept; cost; cost effective; design; disability; exhaustion; frailty; insight; long term hospitalization; mortality; multidisciplinary; novel; older patient; prevent; programs; psychosocial; social; stressor; wasting; Address; Adult; Age; Aging; Anorexia; Behavioral; Biology; Body Weight decreased; Cardiovascular system; Characteristics; Clinical; Cognitive; Cohort Studies; Comorbidity; Complex; Condition; Data; Data Set; Depth; Development; Elderly; Equation; Functional disorder; Gait; Geriatrics; Health; Hospitalization; Impaired cognition; Inflammation; Inflammatory; Institutes; Intervention; Investigation; Knowledge; Lead; Light; Link; Literature; Measures; Medical; Mental disorders; Modeling; Morbidity - disease rate; Muscle; Neurosecretory Systems; Numbers; Outcome; Paper; Pattern; Phenotype; Physical activity; Physiological; Process; Publishing; Range; Research; Research Personnel; Research Project Grants; Resistance; Risk; Role; Sampling; Self Efficacy; Serum Markers; Social support; Syndrome; System; Techniques; Testing; Urine; Work; allostatic load; cognitive function; concept; cost; cost effective; design; disability; exhaustion; frailty; insight; long term hospitalization; mortality; multidisciplinary; novel; older patient; prevent; programs; psychosocial; social; stressor; wasting

DESCRIPTION (provided by applicant): The investigators seek support for an exploratory/developmental research project that will offer new insights into the complex biology and pathophysiology underlying the geriatric syndrome of frailty. Frailty is a topic of great clinical importance to geriatric medicine, but research has been hampered by a lack of an agreed-upon definition of frailty. Valid operational definitions of frailty could greatly enhance research on the causes and consequences of frailty. Though numerous definitions of "frailty" have been proposed in the published literature, the term has usually been used clinically as a global concept to describe a condition, common in the very old, of impaired strength and endurance, increased vulnerability to stressors, and increased risk for morbidity, disability and mortality. In a landmark paper in 2001, Fried and colleagues used data from the Cardiovascular Health Study (CHS) and defined a phenotype of frailty to include 3 or more of the following: unintentional weight loss, weakness, exhaustion, slow gait, and low physical activity level. Older adults found to be frail using this definition were at increased risk for adverse health outcomes, independent of their sociodemographic characteristics, medical comorbidities, and level of disability. This definition provides a useful operational starting point in the quest towards understanding and ultimately preventing and treating frailty, but empiric support of its construct validity is incomplete. This multidisciplinary team proposes to use data previously-collected in the MacArthur Study of Successful Aging (MSSA), a longitudinal cohort study of 1189 older adults, to: 1) use structural equation modeling to test the construct validity of the selected CHS criteria; 2) empirically explore whether the CHS definition of frailty could be enhanced by expanding the definition to include differing criteria that have been hypothesized to be part of frailty (such as cognitive impairment); 3) test whether geriatric frailty is represented by correlated sub-phenotypes (physical, cognitive, behavioral and inflammatory) with different characteristic patterns; and 5) examine the potential role of neuroendocrine, psychosocial and sociodemographic characteristics in predicting frailty. The MSSA offers an extraordinary opportunity to gain new insights into the geriatric syndrome of frailty because this rich dataset includes measures of all 5 of the criteria used in CHS to define frailty, and it also includes rigorous measures of disability and comorbidity, serum markers of inflammation, urine markers of neuroendocrine dysregulation, detailed measures of cognitive function, long-term hospitalization and mortality data, as well as measures of many psychosocial constructs that may be associated with frailty. In summary, this exploratory investigation offers a unique and cost-effective means to break new ground in our understanding of the geriatric syndrome of frailty.

描述（由申请人提供）：调查人员寻求支持探索/发展研究项目，该项目将为脆弱的老年综合症所基于的复杂生物学和病理生理学提供新的见解。脆弱是对老年医学具有极大临床重要性的一个话题，但是由于缺乏对脆弱的商定定义，研究受到了阻碍。脆弱的有效操作定义可以大大增强对脆弱的原因和后果的研究。尽管已在已发表的文献中提出了许多“脆弱”的定义，但该术语通常在临床上用作全球概念，以描述一种在非常古老的，强度和耐力受损的情况下常见的疾病，对压力源的脆弱性增加以及增加的发病率，残疾，残疾和死亡率。在2001年的具有里程碑意义的论文中，Fried及其同事使用了心血管健康研究（CHS）中的数据，并定义了脆弱的表型，其中包括3个或更多的以下数据：意外体重减轻，虚弱，疲惫，步态缓慢和体育活动水平低。使用此定义发现的老年人发现不良健康结果的风险增加，与社会人口统计学特征，医学合并症和残疾水平无关。该定义在寻求理解并最终防止和治疗脆弱的过程中提供了一个有用的操作起点，但是对其结构有效性的经验支持是不完整的。这个多学科团队建议使用先前收集的数据成功的数据（MSSA）（MSSA），这是一项对1189名老年人的纵向队列研究，用于：1）使用结构方程模型来测试所选CHS标准的构造效度； 2）从经验上探讨CHS对脆弱的定义是否可以通过将定义扩展到包括已被认为是脆弱的一部分的不同标准（例如认知障碍）来增强； 3）测试老年脆弱性是否由具有不同特征模式的相关亚表格型（物理，认知，行为和炎症）表示； 5）检查神经内分泌，社会心理和社会人口统计学特征在预测脆弱中的潜在作用。 The MSSA offers an extraordinary opportunity to gain new insights into the geriatric syndrome of frailty because this rich dataset includes measures of all 5 of the criteria used in CHS to define frailty, and it also includes rigorous measures of disability and comorbidity, serum markers of inflammation, urine markers of neuroendocrine dysregulation, detailed measures of cognitive function, long-term hospitalization and mortality数据以及可能与脆弱有关的许多社会心理结构的度量。总而言之，这项探索性调查为我们了解脆弱的老年综合症提供了一种独特且具有成本效益的方式。