Study On The Frailty Status Of Elderly People And Its Influencing Factors

Objectives To understand the frailty degree of community elderly people,explore the related factors in depth,and provide theoretical basis for delaying the frailty of elderly people and realizing the healthy aging.Methods From July 2016 to January 2017,the method of stratified random cluster sampling was adopted to randomly select a secondary hospital and a tertiary hospital from all hospitals at second-class level and above in Tangshan city of Hebei province(8 tertiary hospitals,8 secondary hospitals).All the residents aged 75 and above in the jurisdiction of direct community health service centers or service stations of the two hospitals were selected as the research object,and the questionnaire was conducted.The general demographic questionnaire(including gender,age,marital status,educational level,etc.),The Comprehensive Frailty Assessment Instrument,University of California at Los Angels,Perceived Social Support from Family Scale,Social Support Rating Scale,Health Promotion Lifestyle Profile-? and The MOS Item Short From Health Survey were used as the evaluation tools to investigate the frailty status and the influencing factors of the 3448 elderly people.The database was set up with Excel,and the data was analyzed by SPSS19.0.The enumeration data were described by frequency,and the measurement data were described by mean and standard deviation(?x±s).Single factor measurement data were analyzed by variance analysis or independent sample t test.Factors affecting the frailty of the elderly were analyzed by multiple factors hierarchical regression.The correlation analysis was used to understand the correlation among health promotion lifestyle,loneliness,social support,family support,self-assessment health status and weakness,and the structural equation model was used to analyze the effect mechanism of related factors in the frailty of elderly people.Results 1 The frailty status of elderly people The total average score of the frailty of elderly people was(47.27±11.74)points,including(1.71±0.72)points for physical frailty dimension,(2.07±0.76)points for mental frailty dimension,(2.45±0.55)points for social frailty dimension,and(1.84±0.84)points for environmental frailty dimension.The frailty rate of elderly people was 100%.2 Single factor analysis on the frailty of elderly people The results showed that gender,age,marital status,cultural level,personality type,living style,medical burden,income and expenditure,number of children,the type of chronic diseases,urinary incontinence,life attitude,family support,social support,loneliness,health promotion lifestyle,regular exercise,and self-assessment of health status were associated with the frailty degree of elderly people,and the difference was statistically significant(P<0.05).The frailty degree of elderly people was significantly positively correlated with their loneliness level(r=0.626,P<0.05),which had a significant negative correlation with family support,social support and health promoting lifestyle(r=-0.437,-0.461,-0.452,P<0.05),and had a high negative correlation with self-assessment of health status(r=-0.709,P<0.05).3 Multiple factors analysis on the frailty of elderly people The results showed that the frailty degree of elderly people was influenced by many related variables,and the total explanatory power of related variables for weakness was 66.2%.Among them,the general demographic characteristics and disease related characteristics were 36.6%,family support and social support were 11.9%,the health promotion way of life was 2%,and the self-assessment of health status and loneliness were 15.7%.4 Path analysis of structural equation model The results showed that family support and social support could negatively predict the frailty,and they could also play a negative role in frailty through the mediating effect of loneliness(The mediating effect of loneliness respectively accounted for 28.5% and 36.6% of the total utility).Family support played a mediating role between social support and frailty(The mediating effect of family support accounted for 17.5% of the total utility),and it could also play a negative role in frailty through the mediating role of social support(The mediating effect of social support accounted for 28.8% of the total utility).Loneliness could positively affect the frailty,and played an intermediary role between health promoting lifestyle and frailty(The mediating effect of loneliness accounted for 20.0% of the total utility).Loneliness could also positively predict the frailty through intermediary role of selfassessment of health status(The mediating effect of self-assessment of health status accounted for 51.7% of the total utility).Self-assessment of health status and health promotion lifestyle could negatively predict the frailty,and health promoting lifestyle could also negatively predict the frailty through intermediary role of self-assessment of health status(The mediating effect of self-assessment of health status accounted for 42.4% of the total utility).Conclusions 1 The frailty level of the elderly was moderate,and the degree of social weakness was the most prominent.2 Multifactor analysis showed that the frailty of elderly people was affected by marital status,personality type,medical burden,income and expenditure,the number of children,the type of chronic diseases,urinary incontinence,life attitude,family support,social support,loneliness,health promotion lifestyle,regular exercise,and self-assessment of health status.The medical and health institutions should pay attention to the elderly with divorce/widowhood,introverted personality,heavy burden of medical treatment,liabilities,low number of children,multiple illness,urinary incontinence,negative attitude to life,low family support level,low social support level,strong loneliness,poor health promoting lifestyle,lack of exercise and poor self-assessment of health status,in order to postpone the frailty process and improve quality of life.3 Structural equation model analysis showed that family support,social support,health promoting lifestyle,loneliness,and self-assessment health status could affect the frailty of elderly people through direct or indirect ways.