切换至 "中华医学电子期刊资源库"

中华老年病研究电子杂志 ›› 2023, Vol. 10 ›› Issue (01) : 41 -47. doi: 10.3877/cma.j.issn.2095-8757.2023.01.008

护理园地

老年人内在能力综合评价指标体系的构建
杨舒岚, 江碧艳, 叶蕾, 金肖青, 王钧正, 黄金月, 刘彩霞()   
  1. 310013 杭州,浙江医院护理部
    100872 香港,香港理工大学护理学院
  • 收稿日期:2022-11-30 出版日期:2023-02-28
  • 通信作者: 刘彩霞
  • 基金资助:
    国家科技部重点研发计划项目(2019YFE0113100); 浙江省软科学研究计划项目(2021C35095); 浙江省医药卫生科研计划面上项目(2021KY008); 浙江医院院级项目(2020KYB014)

Construction of a comprehensive evaluation system for assessing intrinsic capacity in community older adults

Shulan Yang, Biyan Jiang, Lei Ye, Xiaoqing Jin, Junzheng Wang, Jinyue Huang, Caixia Liu()   

  1. Nursing Department, Zhejiang Hospital, Hangzhou 310013, China
    School of Nursing, The Hong Kong Polytechnic University, Hongkong 999077, China
  • Received:2022-11-30 Published:2023-02-28
  • Corresponding author: Caixia Liu
引用本文:

杨舒岚, 江碧艳, 叶蕾, 金肖青, 王钧正, 黄金月, 刘彩霞. 老年人内在能力综合评价指标体系的构建[J]. 中华老年病研究电子杂志, 2023, 10(01): 41-47.

Shulan Yang, Biyan Jiang, Lei Ye, Xiaoqing Jin, Junzheng Wang, Jinyue Huang, Caixia Liu. Construction of a comprehensive evaluation system for assessing intrinsic capacity in community older adults[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2023, 10(01): 41-47.

目的

构建老年人内在能力综合评价指标体系,为老年人内在能力综合情况的评定提供科学依据。

方法

以健康老龄化相关研究为理论基础,通过文献分析法构建初级条目池,采用德尔菲法专家咨询确立指标条目,运用层次分析法确定指标权重,形成老年人内在能力综合评价指标体系。

结果

遴选邀请18名专家进行函询,专家问卷有效回收率分别为88.89%、93.75%,专家权威系数分别为0.882、0.900,肯德尔和谐系数分别为0.225、0.227。通过两轮函询构建了老年人内在能力综合评价指标体系,包括5个一级指标、14个二级指标。一级指标的权重从高到低依次为认知功能(0.310)、移动能力(0.184)、视力听力(0.183)、心理社会(0.172)、机体活力(0.151);其中认知功能对应的二级指标权重依次为时间与空间定向(0.116)、记忆力(0.072)、语言能力(0.064)、计算力(0.058),视力听力对应的二级指标权重依次为视力障碍(0.091)、听力障碍(0.091),移动能力对应的二级指标权重依次为行动受限(0.107)、跌倒风险(0.076),心理社会对应的二级指标权重依次为主观感知社会隔离(0.067)、兴趣减退(0.056)、情绪低落(0.050),机体活力对应的二级指标权重依次为营养不良(0.062)、口腔衰弱(0.050)、食欲减退(0.040)。

结论

本研究初步构建了老年人内在能力综合评价指标,为综合评价老年人内在能力提供了可行方案,也为未来基于综合评价进行及早干预奠定了基础。

Objective

To construct a scoring system for assessing intrinsic capacity in older adults, thus to provide scientific guidance on defining the intrinsic capacity among older adults.

Methods

Adopting the theoretical concepts from previous research on healthy aging, the primary set of indexes is constructed through literature analysis. And the content of intrinsic capacity evaluation index system for older adults is determined through Delphi experts consultation. The weighted values of the evaluation indexes are established by the analytic hierarchy process.

Results

Eighteen experts were selected and invited for correspondence consultation. The effective recovery rates of the questionnaires were 88.89% and 93.75%, the expert authority coefficients were 0.882 and 0.900, and the Kendall harmony coefficients were 0.225 and 0.227. After a two-rounded Delphi experts consultation involving 18 experts, an intrinsic capacity evaluation index system for older adults was established, including five first level indexes and 14 secondary indexes. The weights of primary indicators were as follows: cognitive function (0.310), mobility (0.184), vision and hearing (0.183), psycho-social (0.172), and vitality (0.151). The corresponding secondary indicators of cognitive function were time and spatial orientation (0.116), memory (0.072), language ability (0.064), calculate ability (0.058). The corresponding secondary indicators of vision and hearing were visual impairment (0.091), hearing impairment (0.091).The weights of the secondary indicators corresponding to mobility were movement restriction (0.107) and fall risk (0.076). The corresponding secondary index weights of psycho-social were subjective perceived social isolation (0.067), loss of interest (0.056), and depressed (0.050). The corresponding secondary indicators of vitality were malnutrition (0.062), oral frailty (0.050), loss of appetite (0.040).

Conclusion

A comprehensive evaluation index for the intrinsic capacity of the older adults was established, which provides the scheme for comprehensive evaluation of the intrinsic capacity of the older adults, and provides possibility for early intervention based on comprehensive evaluation in the older adults.

表1 老年人内在能力综合评价指标函询结果(±s
第一轮函询 第二轮函询
指标 重要性评分(分) 变异系数 满分比(%) 指标 重要性评分(分) 变异系数 满分比(%)
认知 5.00±0.00 0.000 100.00 认知功能 4.87±0.35 0.072 86.67
记忆力 4.88±0.34 0.070 87.50 记忆力 4.87±0.35 0.072 86.67
时间与空间定向力 4.75±0.58 0.122 81.25 时间与空间定向力 4.80±0.41 0.086 80.00
计算力 4.25±0.86 0.201 50.00 计算力 4.33±0.49 0.113 33.33
语言能力 4.56±0.51 0.112 56.25 语言能力 4.60±0.51 0.110 60.00
心理 4.94±0.25 0.051 93.75 心理社会 4.93±0.26 0.052 93.33
抑郁心境 4.88±0.34 0.070 87.50 情绪低落 4.80±0.41 0.086 80.00
快感缺失 4.75±0.58 0.122 81.25 兴趣减退 4.53±0.52 0.114 53.33
社会隔离 4.75±0.45 0.094 75.00 主观感知社会隔离 4.73±0.46 0.097 73.33
感知觉 4.88±0.34 0.070 87.50 视力听力 4.80±0.41 0.086 80.00
视力障碍 4.81±0.54 0.113 87.50 视力障碍 4.80±0.41 0.086 80.00
听力障碍 4.63±0.62 0.134 68.75 听力障碍 4.80±0.41 0.086 80.00
活力 4.94±0.25 0.051 93.75 机体活力 4.93±0.26 0.052 93.33
体重减轻(营养状态) 4.63±0.62 0.134 68.75 营养不良 4.93±0.26 0.052 93.33
食欲减退(影响营养相关机制) 4.44±0.63 0.142 50.00 食欲减退 4.60±0.51 0.110 60.00
吞咽障碍(影响营养相关机制) 4.81±0.40 0.084 81.25 口腔衰弱 4.33±0.49 0.113 33.33
衰弱/肌少症罹患情况 4.31±1.14 0.264 62.50 - - - -
行动 4.88±0.50 0.103 93.75 移动能力 4.80±0.41 0.086 80.00
行动受限 4.94±0.25 0.051 93.75 行动受限 4.80±0.41 0.086 80.00
跌倒风险 4.88±0.50 0.103 93.75 跌倒风险 4.73±0.80 0.169 86.67
尿失禁罹患情况 4.06±1.18 0.291 43.75 - - - -
图1 老年人内在能力综合评价指标及权重赋值
[1]
联合国.老龄化[EB/OL].[2022-08-17].

URL    
[2]
刘硕,刘晓红.老年人内在能力的研究现状[J].中华老年多器官疾病杂志202221(5):385-388.
[3]
Brooks-Wilson AR. Genetics of healthy aging and longevity[J]. Hum Genet, 2013, 132(12):1323-1338.
[4]
Cesari M, Araujo de Carvalho I, Amuthavalli Thiyagarajan J, et al. Evidence for the domains supporting the construct of intrinsic capacity[J]. J Gerontol A Biol Sci Med Sci, 2018, 73(12):1653-1660.
[5]
Kowal P, Chatterji S, Naidoo N, et al. Data resource profile: the World Health Organization Study on global ageing and adult health (SAGE)[J]. Int J Epidemiol, 2012, 41(6):1639-1649.
[6]
张亚欣,汤哲,杨茗,等.基于德尔菲法构建老年人功能受损评估初始量表[J].中华老年多器官疾病杂志202120(2):86-91.
[7]
张亚欣,汤哲,杨茗,等.老年人功能受损评估正式量表的建立[J].中华老年多器官疾病杂志202120(4):265-269.
[8]
Cesari M, Araujo de Carvalho I, Amuthavalli Thiyagarajan J, et al. Evidence for the domains supporting the construct of intrinsic capacity[J]. J Gerontol A Biol Sci Med Sci, 2018, 73(12):1653-1660.
[9]
World Health Organization. Integrated care for older people: Guidelines on community-level interventions to manage declines in intrinsic capacity[A/OL]. Geneva: World Health Organization, 2017.
[10]
Tavassoli N, de Souto Barreto P, Berbon C, et al. Implementation of the WHO integrated care for older people (ICOPE) programme in clinical practice: a prospective study[J/OL]. Lancet Healthy Longev, 2022, 3(6):e394-e404.
[11]
熊大艳,胡明月,冯辉,等.老年人内在能力现状分析及研究进展[J].中国老年学杂志202040(16):3575-3580.
[12]
Han L, Gill TM, Jones BL, et al. Cognitive aging trajectories and burdens of disability, hospitalization and nursing home admission among community-living older persons[J]. J Gerontol A Biol Sci Med Sci, 2016, 71(6):766-771.
[13]
Langa KM, Levine DA. The diagnosis and management of mild cognitive impairment: A clinical review[J]. JAMA, 2014, 312(23):2551-2561.
[14]
Gill TM, Williams CS, Richardson ED, et al. Impairments in physical performance and cognitive status as predisposing factors for functional dependence among nondisabled older persons[J]. J Gerontol A Biol Sci Med Sci, 1996, 51(6):M283-288.
[15]
Njegovan V, Hing MM, Mitchell SL, et al. The hierarchy of functional loss associated with cognitive decline in older persons[J]. J Gerontol A Biol Sci Med Sci, 2001, 56(10):M638-643.
[16]
Atkinson HH, Rosano C, Simonsick EM, et al. Cognitive function, gait speed decline, and comorbidities: the health, aging and body composition study[J]. J Gerontol A Biol Sci Med Sci, 2007, 62(8):844-850.
[17]
Rowe JW, Kahn RL. Human aging: Usual and successful[J]. Science, 1987, 237(4811):143-149.
[18]
Yang Y, Lv C, Li H, et al. Community-based model for dementia risk screening: The Beijing Aging Brain Rejuvenation Initiative (BABRI) brain health system[J]. J Am Med Dir Assoc, 2021, 22(7):1500-1506.e3.
[19]
Fiske A, Wetherell JL, Gatz M. Depression in older adults[J]. Annu Rev Clin Psychol, 2009, 5:363-389.
[20]
Crocco EA, Castro K, Loewenstein DA. How late-life depression affects cognition: Neural mechanisms[J]. Curr Psychiatry Rep, 2010, 12(1):34-38.
[21]
Vaughan L, Corbin AL, Goveas JS. Depression and frailty in later life: A systematic review[J]. Clin Interv Aging, 2015, 10:1947-1958.
[22]
Penninx BW, Guralnik JM, Ferrucci L, et al. Depressive symptoms and physical decline in community-dwelling older persons[J]. JAMA, 1998, 279(21):1720-1726.
[23]
刘成成,陈利群,谢博钦,等.社区高龄老年人社会隔离现状及影响因素研究[J].护理学杂志202237(13):98-102.
[24]
Crews JE, Campbell VA. Vision impairment and hearing loss among community-dwelling older Americans: Implications for health and functioning[J]. Am J Public Health, 2004, 94(5):823-829.
[25]
Yorgason JB, Tanner CT, Richardson S, et al. The longitudinal association of late-life visual and hearing difficulty and cognitive function: The role of social isolation[J]. J Aging Health, 2022, 34(6-8):765-774.
[26]
Cigolle CT, Langa KM, Kabeto MU, et al. Geriatric conditions and disability: The Health and Retirement Study[J]. Ann Intern Med, 2007, 147(3):156-164.
[27]
Jayakody DMP, Wishart J, Stegeman I, et al. Is there an association between untreated hearing loss and psychosocial outcomes[J]? Front Aging Neurosci, 2022, 14:868673.
[28]
Riera CE, Dillin A. Tipping the metabolic scales towards increased longevity in mammals[J]. Nat Cell Biol, 2015, 17(3):196-203.
[29]
Manini TM. Energy expenditure and aging[J]. Ageing Res Rev, 2010, 9(1):1-11.
[30]
Liao M, Mu Y, Su X, et al. Association between branched-chain amino acid intake and physical function among chinese community-dwelling elderly residents[J]. Nutrients, 2022, 14(20):4367.
[31]
Nieuwenhuizen WF, Weenen H, Rigby P, et al. Older adults and patients in need of nutritional support: Review of current treatment options and factors influencing nutritional intake[J]. Clin Nutr, 2010, 29(2):160-169.
[32]
Abellan van Kan G, Rolland Y, Andrieu S, et al. Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force[J]. J Nutr Health Aging, 2009, 13(10):881-889.
[33]
Soto R, Díaz LA, Rivas V, et al. Frailty and reduced gait speed are independently related to mortality of cirrhotic patients in long-term follow-up[J]. Ann Hepatol, 2021, 25:100327.
[34]
Peterson MD, Casten K, Collins S, et al. Muscle weakness is a prognostic indicator of disability and chronic disease multimorbidity[J]. Exp Gerontol, 2021, 152:111462.
[1] 李凤仪, 李若凡, 高旭, 张超凡. 目标导向液体干预对老年胃肠道肿瘤患者术后血流动力学、胃肠功能恢复的影响[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 29-32.
[2] 晏晴艳, 雍晓梅, 罗洪, 杜敏. 成都地区老年转移性乳腺癌的预后及生存因素研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 636-638.
[3] 李婷婷, 吴荷玉, 张悦, 程康, 张晓芳, 程娅婵. 复合保温策略在老年腹腔镜解剖性肝切除术中的应用研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(05): 522-525.
[4] 刘跃刚, 薛振峰. 腹腔镜腹股沟疝日间手术在老年患者中的安全性分析[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 711-714.
[5] 代格格, 杨丽, 胡媛媛, 周文婷. 手术室综合干预在老年腹股沟疝患者中的应用效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 759-763.
[6] 赵宏霞, 刘静, 李晓薇, 陈金婵, 汪志霞. 腹腔镜下经阴道子宫全切术联合阴道前后壁修补术治疗老年子宫脱垂效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(05): 561-565.
[7] 孙伟, 林丽, 师高洋. 超声引导下连续髂腹股沟-髂腹下神经阻滞与腹横肌平面阻滞在老年腹股沟疝手术中应用效果比较[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(05): 593-597.
[8] 张汪, 徐淑英, 张爱华, 夏芬荣, 汪露. 手术室体温护理结合细节护理干预在老年腹股沟疝围手术期的应用效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(05): 635-638.
[9] 杨鹏, 刘冲. PFNA治疗老年股骨转子间骨折后隐匿性失血及其危险因素的横断面研究[J]. 中华老年骨科与康复电子杂志, 2023, 09(05): 301-306.
[10] 单秋洁, 孙立柱, 徐宜全, 王之霞, 徐妍, 马浩, 刘田田. 中老年食管癌患者调强放射治疗期间放射性肺损伤风险模型构建及应用[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 388-393.
[11] 姜里蛟, 张峰, 周玉萍. 多学科诊疗模式救治老年急性非静脉曲张性上消化道大出血患者的临床观察[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 520-524.
[12] 毛树文, 袁方, 唐昊, 王建民. 针刀调节交感神经对老年胃溃疡患者胃功能和溃疡愈合的影响[J]. 中华消化病与影像杂志(电子版), 2023, 13(05): 326-330.
[13] 郭震天, 张宗明, 赵月, 刘立民, 张翀, 刘卓, 齐晖, 田坤. 机器学习算法预测老年急性胆囊炎术后住院时间探索[J]. 中华临床医师杂志(电子版), 2023, 17(9): 955-961.
[14] 晏美娟, 邵礼晖. 高水平脂蛋白(a)与无“三高”老年人群小动脉硬化型脑小血管病的相关性研究[J]. 中华脑血管病杂志(电子版), 2023, 17(05): 458-463.
[15] 邓颖, 黄山, 胡慧秀, 孙超. 老年缺血性脑卒中患者危险因素聚集情况分析[J]. 中华脑血管病杂志(电子版), 2023, 17(04): 344-349.
阅读次数
全文


摘要