1.武汉大学中南医院老年医学科 湖北 武汉 430071
2.武汉大学护理学院老龄化研究中心 湖北 武汉 430071
吕放,男,1997—,医学硕士,主要从事中老年人群衰弱状况的研究,E‑mail: 2021283030121@whu.edu.cn
叶旭军,男,1971—,副教授,主任医师,主要从事老年医学、老年慢性病学相关研究,E‑mail: wdxjy@whu.edu.cn
收稿:2024-01-20,
纸质出版:2025-06-25
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吕放,王紫薇,李行等.中国中老年人群婚姻状况与衰弱进展的关系[J].武汉大学学报(医学版),2025,46(06):793-798.
LÜ Fang,WANG Ziwei,LI Hang,et al.Association between marital status and the progression of frailty among middle‑aged and older adults in China[J].Medical Journal of Wuhan University,2025,46(06):793-798.
吕放,王紫薇,李行等.中国中老年人群婚姻状况与衰弱进展的关系[J].武汉大学学报(医学版),2025,46(06):793-798. DOI: 10.14188/j.1671-8852.2024.0079.
LÜ Fang,WANG Ziwei,LI Hang,et al.Association between marital status and the progression of frailty among middle‑aged and older adults in China[J].Medical Journal of Wuhan University,2025,46(06):793-798. DOI: 10.14188/j.1671-8852.2024.0079.
目的
2
探索中国中老年人群婚姻状况与衰弱进展之间的关系,同时探讨其性别间的差异。
方法
2
该研究纳入2011年来自中国健康与养老追踪调查(CHARLS)的8 490名45岁及以上的参与者。研究使用衰弱指数(FI)评估衰弱的进展情况。使用CHARLS中的婚姻状况问卷将参与者分为观察组(无伴侣共同生活:分居、离异、丧偶及未婚)和对照组(有伴侣共同生活:已婚或暂时分居)。使用Cox比例风险回归模型分析婚姻状况和衰弱进展之间的关系。随访结局为衰弱、全因死亡。
结果
2
总体人群分析显示,观察组发生衰弱的风险显著高于对照组(
HR
:1.21;95%
CI
:1.00~1.48)。根据性别进行亚组分析后发现,在男性中,观察组的死亡风险显著高于对照组(
HR
:1.31;
95%
CI
:1.01~1.71)。而在女性中,观察组发生衰弱的风险显著高于对照组(
HR
:1.31;95%
CI
:1.02~1.67)。
结论
2
婚姻状况是影响中老年人群衰弱进展和死亡的重要因素。在女性中,婚姻状况与衰弱的关联更强;而在男性中则主要影响人群的死亡率。研究结果提示在评估衰弱风险及进展时需要更多的关注寡居老人。
Objective
2
To explore the relationship between marital status and frailty progression and its gender differences among middle‑aged and elderly individuals in China.
Methods
2
The study included participants aged 45 and above from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011. To evaluate the progression of frailty
the researchers employed a frailty index (FI)
which was developed based on the accumulation of health‑related deficits. Participants were grouped based on their marital status using the marriage status questionnaire in CHARLS: Observation group (living without a partner: separated
divorced
widowed
or never married) and control group (living with a partner: married or temporarily separated). The relationship between marital status and frailty progression was analyzed using Cox proportional hazards regression models. Follow‑up outcomes included frailty and all‑cause mortality.
Results
2
The hazard risk of developing frailty was significantly higher in the observation group as compared with that in the control group (
HR
: 1.21; 95%
CI
: 1.00‑1.48). This suggests that individuals in the observation group were more prone to frailty than those in the control group. However
when examining gender‑specific results
distinct differences emerged. Among males
the hazard risk of mortality was significantly higher in the observation group as compared with that in the control group (
HR
: 1.31; 95%
CI
: 1.01‑1.71). In females
the hazard risk of frailty was significantly higher in the observation group than in the control group (
HR
: 1.31; 95%
CI
: 1.02‑1.67).
Conclusion
2
Marital status is a significant factor influencing frailty progression and mortality in middle‑aged and elderly populations. In females
the association between marital status and frailty is stronger
while in males
marital status primarily impacts the overall mortality rate. The research findings suggest that more attention should be given to widowed elderly individuals when assessing frailty risk and progression in populations.
HOOGENDIJK E O , AFILALO J , ENSRUD K E , et al . Frailty: Implications for clinical practice and public health [J ] . Lancet , 2019 , 394 ( 10206 ): 1365 ‑ 1375 .
MORLEY J E , VELLAS B , VAN KAN G A , et al . Frailty consensus: A call to action [J ] . J Am Med Dir Assoc , 2013 , 14 ( 6 ): 392 ‑ 397 .
CLEGG A , YOUNG J , ILIFFE S , et al . Frailty in elderly people [J ] . Lancet , 2013 , 381 ( 9868 ): 752 ‑ 762 .
STRANDBERG T E , PITKÄLÄ K H . Frailty in elderly people [J ] . Lancet , 2007 , 369 ( 9570 ): 1328 ‑ 1329 .
DORNER T E , LACKINGER C , HAIDER S , et al . Nutritional intervention and physical training in malnourished frail community‑dwelling elderly persons carried out by trained lay "buddies": Study protocol of a randomized controlled trial [J ] . BMC Public Health , 2013 , 13 : 1232 .
BU F , DENG X H , ZHAN N N , et al . Development and validation of a risk prediction model for frailty in patients with diabetes [J ] . BMC Geriatr , 2023 , 23 ( 1 ): 172 .
KOJIMA G , WALTERS K , ILIFFE S , et al . Marital status and risk of physical frailty: A systematic review and meta‑analysis [J ] . J Am Med Dir Assoc , 2020 , 21 ( 3 ): 322 ‑ 330 .
SEARLE S D , MITNITSKI A , GAHBAUER E A , et al . A standard procedure for creating a frailty index [J ] . BMC Geriatr , 2008 , 8 : 24 .
HE D , QIU Y W , YAN M S , et al . Associations of metabolic heterogeneity of obesity with frailty progression: Results from two prospective cohorts [J ] . J Cachexia Sarcopenia Muscle , 2023 , 14 ( 1 ): 632 ‑ 641 .
FAN J N , YU C Q , GUO Y , et al . Frailty index and all‑cause and cause‑specific mortality in Chinese adults: A prospective cohort study [J ] . Lancet Public Health , 2020 , 5 ( 12 ): e650 ‑ e660 .
SARAVANAKUMAR P , BALACHANDRAN A , MUHAMMAD T , et al . Wealth disparity and frailty among community‑dwelling older adults in India [J ] . BMC Public Health , 2022 , 22 ( 1 ): 2123 .
TREVISAN C , VERONESE N , MAGGI S , et al . Marital status and frailty in older people: Gender differences in the progetto Veneto anziani longitudinal study [J ] . J Womens Health , 2016 , 25 ( 6 ): 630 ‑ 637 .
ALODHAYANI A , ALMUTAIRI K M , VINLUAN J M , et al . Association between self‑care management practices and glycemic control of patients with type 2 diabetes mellitus in Saud Arabia: A cross‑sectional study [J ] . Saudi J Biol Sci , 2021 , 28 ( 4 ): 2460 ‑ 2465 .
KIECOLT‑GLASER J K , WILSON S J . Lovesick: How couples' relationships influence health [J ] . Annu Rev Clin Psychol , 2017 , 13 : 421 ‑ 443 .
MANFREDINI R , DE GIORGI A , TISEO R , et al . Marital status, cardiovascular diseases, and cardiovascular risk factors: A review of the evidence [J ] . J Womens Health , 2017 , 26 ( 6 ): 624 ‑ 632 .
SIPILÄ S , TÖRMÄKANGAS T , SILLANPÄÄ E , et al . Muscle and bone mass in middle‑aged women: Role of menopausal status and physical activity [J ] . J Cachexia Sarcopenia Muscle , 2020 , 11 ( 3 ): 698 ‑ 709 .
ESHRE Capri Workshop Group . Perimenopausal risk factors and future health [J ] . Hum Reprod Update , 2011 , 17 ( 5 ): 706 ‑ 717 .
DING Z , YU D S , LI H F , et al . Effects of marital status on overall and cancer‑specific survival in laryngeal cancer patients: A population‑based study [J ] . Sci Rep , 2021 , 11 ( 1 ): 723 .
QIAN L H , CHEN Y X , PENG M Y , et al . The importance of marital status in the morbidity and prognosis of lung metastasis in newly diagnosed ovarian cancer [J ] . J Cancer , 2023 , 14 ( 6 ): 1024 ‑ 1038 .
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