| Purpose : For the elderly in the pre-frailty,their constitutions of Traditional Chinese Medicine(TCM)and current status of quality of life were evaluated,combined with the preliminary study on the internal relation between TCM constitutions and quality of life.It provides a theoretical basis for the diagnosis and treatment of senile pre-frailty,and new ideas for the TCM clinical prevention and treatment of senile frailty.Material and method:This study has passed ethical review of the Ethics Committee of Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,and completed the registration in the Chinese Clinical Trial Registry(Chi CTR).Ethical Approval No.2019056FS(KT)-034-02.A cross-sectional survey was conducted.Elderly people at and above the age of 60 had been studied from December 2019 to December 2020.The subjects,from communities in Shenyang and Jinzhou,Liaoning Province and the outpatient department of geriatrics in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,were divided into pre-frailty group(200 cases)and normal group(200 cases)after being screened by Fired criteria for frailty syndrome.The two groups of elderly people completed questionnaires by one-to-one doctor-patient communication,including general information,classification pf TCM constitutions and decision table,and the Concise Health Status Questionnaire(SF-36).Their TCM constitutions and quality of life were analyzed,conducting data reduction by Excel and data analysis by SPSS Statistics 22.Mean ± standard deviation was used for statistical description of measurement data,with frequency and constituent ratio used for statistical description of enumeration data and the chi-square test used for statistical inference.If the theoretical frequency N<40,Fisher's exact probability test will be used.Wilcoxon's rank sum test was used for statistical inference of ranked data.The choice of logistic regression is to explore the factors influencing pre-frailty and the choice of Spearman rank correlation is to explore the correlation factors of quality of life.Inspection level ?=0.05,P < 0.05 indicated statistically significant difference and P < 0.01 indicated conspicuous difference.This study has passed ethical review and completed the registration in the Chinese Clinical Trial Registry(Chi CTR).Results:1.464 elderly people investigated in this study included 35 cases in frailty and 429 cases in pre-frailty.Finally,400 cases were selected for this study,including 200 cases in normal group and 200 cases in pre-frailty,excluding 26 cases without sufficient information and 3cases without available data.2.The results of this study were statistically significant on comparison of the differences of age,the category of chronic diseases,personality,the types of occupation,entertainment,travel experience,the number of children between the pre-frailty group and the normal group(P < 0.05),with age,personality,the number of children,entertainment presenting conspicuous difference(P < 0.01).The differences of gender,spouse,surgical experience,parent-child relationship,interpersonal relation with people whom they live with,place of residence and situation of the elderly people's children visiting them between the pre-frailty group and the normal group were not statistically significant(P > 0.05).The differences in hypertension,coronary heart disease and cerebrovascular disease among chronic diseases between the two groups were statistically significant(P < 0.05),while the differences in diabetes,osteoporosis,chronic lung disease,hyperlipidemia and chronic kidney disease among chronic diseases between the two groups were not statistically significant(P > 0.05).3.The results of logistic regression analysis in the pre-frailty showed the variables into equation,age(OR = 2.381,P < 0.01),the number of chronic diseases(OR = 1.358,P < 0.01),personality(introversion,OR = 2.274,P < 0.01;extroversion,OR = 1.221,P>0.05),types of occupation(mental type,OR = 0.215,P < 0.01;Physical type,OR=0.306,P>0.05),and the number of children(OR = 1.879,P < 0.01),entertainment(OR=0.624,P > 0.05),travel experience(OR=0.900,P>0.05).4.35 cases of yin-yang harmony constitution(17.5%)and 165 cases of the biased constitutions(82.5%)were in the pre-frailty group.The top three of the cases of the biased constitutions were 55 cases of yang-qi deficiency constitution(27.5%),39 cases of qi deficiency constitution(19.5%)and 24 cases of yin deficiency constitution(12%).In the normal group,there were 82 cases of yin-yang harmony constitution(41 %)and 118 cases of the biased constitutions(59%).The top three of the biased constitutions were 42 cases of yang-qi deficiency constitution(21%),27 cases of qi deficiency constitution(13.5%),and 20 cases of yin deficiency constitution(10%).The differences of nine constitutions of the elderly in the two groups were statistically significant(P = 0.000),and so were the differences of normal constitutions and the biased constitutions in the two groups(P = 0.000).5.The yin-yang harmony constitution was the most common among the men(21%)and women(20%)in the normal group.The distribution of the body constitutions of both men and women was not statistically significant in the normal group(P > 0.05).The men in the pre-frailty were more likely to be yang-qi deficiency constitution(11.5%),with the women in the same group being qi deficiency(17.5%).The distribution of body constitutions of different genders in the pre-frailty group was statistically significant(P < 0.05).6.In the normal group,there were 74 cases of the biased constitutions and 58 cases of yin-yang harmony constitution among 60?69 years old people,37 cases of the biased constitutions and 21 cases of yin-yang harmony constitution among 70?79 years old people,and 7 cases of the biased constitutions and 3 cases of yin-yang harmony constitution among people at and above the age of 80.The biased constitutions of the elderly of different ages in the normal group were not statistically significant(P > 0.05).Among the 60?69 years old people in the pre-frailty group,70 cases of the biased constitutions and 18 cases of yin-yang harmony constitution were included,with 70 cases of the biased constitutions and 14 cases of yin-yang harmony constitution among 70?79 years old people,and 25 cases of the biased constitutions and 3 cases of yin-yang harmony constitution among the elderly at and above the age of 80.The biased constitutions of the elderly of different ages in the pre-frailty group were not statistically significant(P > 0.05).7.The results of Logistic regression analysis of biased constitution on pre-frailty showed that yang deficiency constitution(OR = 0.213,P < 0.01),qi deficiency constitution(OR = 0.665,P > 0.05),yin deficiency constitution(OR = 0.722,P > 0.05),phlegm dampness constitution(OR = 0.600,P > 0.05),qi stagnation constitution(OR = 0.778,P > 0.05).8.The total score in quality of life of the elderly in the pre-frailty group was(105.79 ± 16.07).And the other eight dimensions ranged in score from high to low,which were social function(SF)(70.50 ± 27.19),bodily pain(BP)(70.03 ± 21.10),physical function(PF)(67.60 ± 27.00),role emotional(RE)(64.17 ± 39.71),mental health(MH)(58.86 ± 18.37),vitality(VT)(57.95± 17.53),role physical(RP)(44.25 ±42.55),and general health(GH)(36.50 ± 10.78).In addition,the scores in physical component summary(PCS)and mental component summary(MCS)were respectively(66.52±17.53)and(57.17±17.39).9.The total score in quality of life of the elderly in the normal group was(117.79 ± 14.19).And the other eight dimensions ranged in score from high to low,which were social function(SF)(84.20 ± 17.01),bodily pain(BP)(80.65 ± 17.22),physical function(PF)(76.50 ± 34.77),role emotional(RE)(69.13 ± 40.00),mental health(MH)(58.86 ± 18.37),vitality(VT)(67.45± 16.67),role physical(RP)(66.74 ± 18.62),and general health(GH)(41.95 ± 10.95).In addition,the scores in physical component summary(PCS)and mental component summary(MCS)were respectively(79.71±13.44)and(67.44±17.43).10.Among the elderly with yin-yang harmony constitution and yang-qi deficiency,there were significant differences in the quality of life between pre-frailty group and normal group(P <0.01),and the quality of life in normal group was higher than that in pre-frailty group.There was no statistical difference in other constitutions.11.According to the results of Spearmen rank correlation analysis,quality of life was negatively correlated with pre-frailty,coexistence of chronic diseases,two or more children,introversion,and living in their own homes.The r values were-0.350,-0.172,-0.145,-0.142,-0.108 and the corresponding P values were respectively P<0.01,P<0.01,P<0.01,P<0.01,P<0.05.Yin-yang harmony constitution,participation in recreational activities,and gentle personality were positively correlated with quality of life(r =0.164,r =0.135,r =0.099;P < 0.01,P < 0.01,P< 0.05 respectively).Conclusion:1.Age,the number of chronic diseases,personality,the types of occupation before retirement and the number of children were all the influencing factors for the pre-frailty of old age,among which,increase of age,coexistence of chronic diseases,introversion and the more children were considered to be the risk factors for pre-frailty,while mental occupation was considered as a protective factor for pre-frailty.2.In the pre-frailty,yang-qi deficiency,qi deficiency and yin deficiency constitutions are the main constitution types.The older they are,the higher proportion the biased constitution accounts for.Yang-qi deficiency was a risk factor for pre-frailty compared with yin-yang harmony constitution.3.The quality of life of the elderly without frailty in all dimensions was better than that of the elderly in pre-frailty.4.The quality of life of the elderly was negatively correlated with pre-frailty,co-existence of chronic diseases,two or more children,introversion,living in their own homes,and positively correlated with yin-yang harmony constitution,participation in recreational activities,and gentle personality. |
PDF Full Text Request