老年糖尿病患者衰弱潜在剖面分析及影响因素

doi:10.3969/j.issn.1674-490X.2025.02.006

摘要/Abstract

摘要： 目的探讨老年糖尿病患者衰弱的现状及潜在类别,并探讨不同类别的影响因素。方法采用定点连续取样,选取2023年3—10月在保定市某三级甲等医院内分泌科住院的老年糖尿病患者为研究对象,采用一般资料调查表、匹兹堡睡眠质量指数量表、糖尿病自我管理量表、Tilburg衰弱量表、微型营养评估简表、Barthel 指数评定量表、简版老年抑郁量表进行调查。使用Mplus 8.3软件对衰弱进行潜在剖面分析,使用SPSS 24.0 进行各潜在类别的单因素及多元Logistic回归分析。结果纳入的379例老年糖尿病患者,其衰弱的发生率为51.18%。老年糖尿病患者衰弱可分为“低衰弱”(52.77%)、“中衰弱”(26.65%)、“高衰弱”(20.58%)3个潜在类别。自我管理能力及日常生活活动能力越强、糖化血红蛋白水平越低的患者倾向于“低衰弱”,伴有睡眠障碍、无饮酒史的患者倾向于“中衰弱”,处于抑郁状态、运动频率低的患者倾向于“高衰弱”。结论老年糖尿病患者的衰弱存在异质性,不同潜在类别影响因素不同,为构建精准干预方案提供了依据。

关键词: 老年糖尿病, 衰弱, 潜在类别, 影响因素

Abstract: Objective To investigate the frailty status, latent profiles, and influencing factors in elderly patients with diabetes. Methods A consecutive sampling method was used to enroll elderly inpatients with diabetes from the endocrinology department of a three A grade hospital in Baoding city between March and October 2023. Data were collected using standardized instruments: General Information Questionnaire, Pittsburgh Sleep Quality Index(PSQI), Diabetes Self-Management Questionnaire(DSMQ), Tilburg Frailty Indicator(TFI), Shortform Mini-Nutritional Assessment(MNA-SF), Barthel Index(BI), and Geriatric Depression Scale-15(GDS-15). Latent profile analysis was performed using Mplus 8.3 to classify frailty subtypes, while SPSS 24.0 was employed for univariate and multivariate logistic regression analyses. Results Among 379 participants, the frailty prevalence was 51.18%. Three latent frailty profiles were identified: “low frailty”(52.77%), “moderate frailty”(26.65%), and “high frailty”(20.58%). Patients with stronger self-care ability, better activities of daily living, and lower HbA1c levels tended to cluster in the “low frailty” group. Those with sleep disorders or no alcohol consumption history were more likely to be categorized as “moderate frailty,” while individuals with depressive symptoms and lower exercise frequency predominantly fell into the “high frailty” group. Conclusion Frailty in elderly diabetic patients demonstrates heterogeneity with distinct influencing factors across latent profiles. These findings provide a foundation for developing tailored intervention strategies based on frailty subtypes.

Key words: elderly patients with diabetes, frailty, latent profile analysis, influencing factors

中图分类号:

R473.5

张秀梅,刘玉涵,张若彤,尹园园,井坤娟. 老年糖尿病患者衰弱潜在剖面分析及影响因素[J]. 医学研究与教育, 2025, 42(2): 52-65.

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