일부 지역사회 거주 노인들의 노쇠수준과 기능장애의 연관성 및 노쇠 관련요인
Correlation between Frailty Level and Disability of the Elderly and Frailty Related Factors
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연구배경: 노쇠는 노화에 따른 생리적 기능감소, 예비능력 저 하 및 신체계통의 조절장애에 의한 증상을 보이는 소모성 증 후군으로 현재 노인의학에서 중요한 연구과제이다. 이에 이 번 연구는 우리나라 노인의 노쇠의 수준 및 노쇠가 노인의 기 능 장애에 있어 유의한 예측인자가 될 수 있는 지를 알아 보고 자 하였다. 방법: 2008년 2월부터 2008년 6월 사이 서울 및 경기 시내 의 복지관 세 곳에 방문하는 만 65세 이상의 남녀 302명을 대상으로 인구학적 특성, 만성질환 유무, 복용약물 개수, Cardiovascular Health Study (CHS) 노쇠지수, Study of Osteoporotic Fractures (SOF) 노쇠지수, 일상생활 수행능력, 도구적 인 일상생활 수행능력, 우울, 한국형 간이 정신상태 검사 및 낙 상력 등을 조사하였다. 결과: 연령, 교육수준, 결혼상태, 월수입, 체질량지수, 만성질 환 개수 및 복용약물 수, 우울감, 인지능력(MMSE), 낙상력 등 이 노쇠의 단계별로 차이를 보였다. 노쇠 지표간의 로지스틱 회귀분석에서는 SOF 노쇠 지표에 따라 건강한 단계에서 노쇠 전 단계로 갈수록 IADL이 의존을 보일 교차비가 7.92배(95% 신뢰구간, 2.07-30.19), 노쇠 단계에서는 69.58배(95% 신뢰구 간: 18.80-257.51) 증가하였고, 이는 단변량분석에서 기능장 애와 상관관계를 보인 다른 변수들을 보정한 후에도 여전히 증가하였고 CHS 노쇠 지표에서도 교차비의 차이는 있지만 같 은 결과를 보였다. 결론: 도시지역 복지관을 방문하는 우리나라 노인들의 노쇠 관련요인은 고령, 낮은 교육수준 및 경제수준, 많은 동반질환, 우울감, 저하된 인지능력, 많은 낙상력 등이었고, 노쇠를 건강, 노쇠 전 단계, 노쇠 단계로 구분시 노쇠단계로 갈수록 기능장 애와 유의한 상관관계를 보였다.
Abstract
Background: Frailty is a wasting syndrome that presents loss of physiological function by aging, lowering of reserve capacity, and disability of body system. It is currently being considered an important issue in geriatrics. This study examined frailty level of Korean elderly in community and whether frailty can be meaningful a predictive factor for functional disability. Methods: Demographic characteristics, the number of chronic diseases and medications, cardiovascular health study (CHS) frailty index, study of osteoporotic fractures (SOF) frailty index, activities of daily living, Instrumental activities of daily living, depression, mini-mental state examination (MMSE) and fall history were examined for 302 men and women over 65 years old who visited the three community seniors welfare centers from February 2008 to June 2008. Results: There were defi nite differences of frailty status by age, educational level, marital status, monthly income, body mass index, the number of chronic diseases, the number of medications, depression, MMSE and fall history (P < 0.05), except in gender (P < 0.432). In logistic regression analysis for functional disability with frailty status defi ned by SOF frailty index, odds ratio to dependency of instrumental activities of daily living (IADL) from the healthy to the prefrail stage increased 6.84 times while from the healthy to the frail stage increased 130.87 times. These effects still increased after covariate adjustment. Also, the CHS frailty index showed the same result although there was some difference in odds ratio. Conclusion: There were meaningful correlations of frailty with functional disability when dividing Korean elderly’s frailty levels into the healthy, the prefrail and the frail stages.
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