| ObjectivesThe study was conducted under the background of"Health Aging"program.The study aimed to investigate and analyze the physical,psychological and other related index of the elderly.In addition,it aimed to examine the associated factors of frailty and the relationship between frailty and the quality of life among elderly.The study also contained a randomized control trial to explore the effect of health management on resilience,self care ability,quality of life,and physiological outcomes among pre-frail elderly.Methods1.Literature and Theory analysis was conducted to describe research progress of the frail condition,influential factors,adverse physiological outcomes,and interventions for the elderly in national and international.And to study the effect of health management on physiological outcomes of the frail elderly.2.A total of 578 older adults aged 60 and over living in 5 communities in Tai'an city were recruited by convenience sampling.A cross-sectional survey was conducted,and frailty was assessed by the Fried frailty phenotype;general information was collected by general information questionnaire;health promotion behavior,depression,resilience,self care ability and quality of life were assessed by Chinese version of the elderly health prom-oting lifestyle scale(HPLP-CE),short version of the geriatric depression scale(GDS-15),resilience scale(RS-14),self-care ability scale for the elderly(SASE)and short form of the world health organization quality of life measurement scale(WHOQOL-BREF)separately.The study applies SPSS21.0 statistical software for analysis of data.The incidence of frailty and pre-frailty and the basic characteristics of the respondents were summarized in this paper;The influence factors of frailty were analyzed by establishing a multivariate Logistic Regression Model;The correlation analysis were used to explore the relationship of frailty score,resilience,self care ability and quality of life,and the Structural Equation Model of frailty score affecting the quality of life among elderly was building by AMOS statistics software.3.Totally 120 pre-frail elderly in 5 communities in Tai'an city were divided in two groups based on their health file number by randomized controlled trial design.And there are 60 cases in each group.Control group was given routine community health manage-ment,and intervention group was given routine community health management and health management which was given priority to sport training for 3 months,and follow-up 3months.The two groups were all assessed on frail status,resistance level,self care ability,quality of life,and biological indicators before intervention,after intervention for 3 months,6 months;The elderly of two groups were all assessed resilience level,self care ability and quality of life again in the center of the community health service;The frailty condition of the elderly was assessed at 6 months after intervention,meanwhile,collecting the Height,Weight,Body Mass Index(BMI),Waist,Blood Pressure,Blood Lipid,Fasting Blood Glucose biological indicators.SPSS21.0 and Graphad Prism5 statistical software were used for data collection and analysis,including descriptive analysis,t test,?~2 test,repetitive measure analysis of variance,et al.Results1.A theoretical framework to guide the entire study was established based on litera-ture analysis and theoretical research.2.The investigative results:Firstly,a total of 578 old people were investigated in this study,266(46.0%)elders were robust,224(38.8%)elders were pre-frailty,and 88(15.2%)elders were frailty,with an average age of 71.87±8.400.Secondly,the total score of health promoting lifestyle in the elderly was 53.49±7.15;The total score of depression was2.76±2.00;The total score of resilience was78.65±8.16;The total score of self care ability was 70.63±8.56;The total score of quality of life was 65.48±5.85,and the subscale of physical,psychological,social relations and environment was 66.87±9.55,68.33±7.12,62.66±10.54,63.18±6.37 respectively.Thirdly,Multiple Logistic Regression Analysis showed that the influence factors of frailty of the elderly included gender,age,exercises,polypharmacy,fall,pain,LDL,and nutrition behavior.Fourthly,the majority of the elderly had positive comments on their overall quality of life(60.9%)and health status(49.8%),and the total score of quality of life among robust,pre-frail and frail old people was significant decreasing in turn(P<0.01).Fifthly,The frailty scores was negatively related to the resilience,self care ability and quality of life in the elderly(r=-0.279,-0.385,-0.485,P<0.01);Resilience was positively related to the self-care ability and quality of life(r=0.512,0.581,P<0.01).Sixthly,Structural Equation Modeling analysis indicated that frailty scores directly predict the quality of life of the elderly(?=0.239,P<0.001),meanwhile,resilience and self-care ability had a partial mediating effect between frailty and quality of life(intermediary effect accounted for 61.7%of the total effect).3.The intervention research results:Firstly,totally 120 subjects were enrolled in the study,there were 60 elders for the control group and 60 elders for the intervention group,and conducting intention to treat analysis of 7 cases who were dropped to follow-up.Before the intervention,there were no significant differences between the two groups in the score of the studying variables.Secondly,scale score comparison:After intervention for 6 month,there was a significantly statistical difference in changes in the resilience score(P<0.01),and there was an interaction effect in the two groups between time factors and group factors(F=6.102,P<0.01),that was to say after intervention there was a differ-ent trend of resilience between the intervention group and control group;After the intervention,there was a significantly statistical difference in the self care ability between the two groups,the score of self care ability in the intervention group was significantly greater than the control group(P<0.01).After the intervention for 6 months,there was a significantly statistical difference in changes in the quality of life score(P<0.01),and there was a interaction effect in the two groups on the old people's score of quality of life and physical and social relations domain between time factors and group factors(F=6.917,3.356,5.031,P<0.01),that was to say after intervention there was a different trend of qual-ity of life between the intervention group and control group.Thirdly,biological indexes comparison:After intervention there were great differences in changes in BMI and SBP level between the intervention group and control group(P<0.05).There were significant differences in changes in BMI,SBP and PP level in the intervention group(P<0.05).Fourthly:the negative conversion ratio of frailty in the intervention group was obviously better than the control group,and has a statistically significant difference(P<0.05).Conclusions1.The average level of overall health was in the medium level among community dwelling elderly in Tai'an city,and the prevalence of pre-frailty was 38.8%,frailty was15.2%.2.The frailty status was influenced by multiple correlated variables,we should pay special attention to the elderly who are older,female and polypharmacy,fall,pain,high LDL levels.3.The frailty not only directly affects the quality of life,but also via resilience and self care ability indirectly affect the quality of life.4.Health management intervention,which was given priority to sports training can significantly improve the level of resilience,promote self care ability,improve the quality of life,reduce the level of BMI,SBP,and slow down or even reverse the incidence of the pre-frail elderly in this area. |
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