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标题：Mexican Americans and Frailty: Findings From the Hispanic Established Populations Epidemiologic Studies of the Elderly
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作者：Kenneth J. Ottenbacher ; James E. Graham ; Soham Al Snih 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2009
卷号：99
期号：4
页码：673-679
DOI：10.2105/AJPH.2008.143958
语种：English
出版社：American Public Health Association
摘要：Objectives. We examined the prevalence of frailty among Mexican American older adults and explored the correlates associated with becoming frail to determine their affect on disability and morbidity in this population. Methods. We studied the trajectory of frailty over 10 years in 2049 Mexican Americans participating in the Hispanic Established Populations Epidemiologic Studies of the Elderly. We constructed a frailty index based on weight loss, exhaustion, grip strength, walking speed, and physical activity and collected data on sociodemographic and health status, comorbidities, and functional measures of performance. Results. The sample was 58% female, with a mean age of 74.43 years (SD = 6.04) at baseline. Fifty-five percent of participants at baseline and 75% of the surviving sample at follow-up (n = 777) were classified as prefrail or frail. Of persons identified as frail at baseline, 84% died by the end of follow-up. Baseline age, diabetes, arthritis, smoking status, body mass index, cognition, negative affect, and number of comorbid conditions were predictors of frailty at follow-up ( R ² = 0.29; P < .05). Conclusions. Further research into ways to reduce the number of Mexican American older adults who become frail and disabled and therefore lose their independence is needed. Future studies should continue to examine the trajectory of frailty as a dynamic process that includes psychosocial and cognitive components. Frailty has been identified as a precursor to disability, institutionalization, and mortality in older adults.^{1 , 2} Research on frailty among minority older adults and underserved populations is sparse despite evidence of cultural and physiological differences among racial and ethnic groups.^{3 , 4} We know, for example, that Hispanics have a high incidence of diabetes and obesity and poor access to primary care compared with non-Hispanic Whites.⁴ These factors potentially affect the development of frailty in this population in ways that are currently unknown. We sought to systematically examine who becomes frail in a large well-defined sample of Mexican American older adults studied over 10 years. Our primary aim was to determine, by an established definition, the change in prevalence of frailty. We selected the index proposed by Fried and Walston⁵ to define frailty because the index (1) is comprehensive and multifactorial, (2) provides a measure of frailty that can be used in clinics and the community, and (3) is the most widely cited and discussed definition in the aging literature.^{6 , 7} We acknowledge, however, that definitions of frailty are still under discussion among researchers in this field.^{2 , 8 , 9} Our secondary aim was to explore the correlates associated with becoming frail among Mexican American older adults. We hypothesized that frailty represents a dynamic process and that persons can become both more and less frail over time.¹⁰ We also hypothesized, based on previous findings,⁶ that age, number of comorbidities, ability to perform activities of daily living, and measures of lower-extremity physical performance would be associated with increased incidence of frailty.