目的：调查住院老年高血压合并糖尿病患者衰弱现状并分析其影响因素。方法：选取海南省某三甲医院≥65岁的高血压合并糖尿病患者306例为研究对象，采用一般情况调查表收集一般资料，采用Fried衰弱量表评估患者衰弱情况，采用简易智力状态检查量表(MMSE)、基本日常生活能力(BADL)、工具性日常生活能力(IADL)、简易躯体功能评定(SPPB)、焦虑自评量表(SAS)、抑郁评定量表简表(GDS-15) 等问卷评估患者智力状态、日常生活能力、焦虑、抑郁等情况。单因素分析采用χ²检验和Mann-Whitney U检验，多因素分析采用Logistic回归分析衰弱的影响因素。 结果：老年高血压合并糖尿病患者衰弱的发生率为43.1%。多因素回归分析结果显示,年龄75~84岁(OR=2.5，95% CI 1.397~4.475)及≥85岁(OR=4.439，95% CI 2.020~9.754)、很差的躯体功能(OR=2.997，95% CI 1.523~5.898)、抑郁(OR=2.248，95%CI 1.273~3.970)、基本日常生活重度失能(OR=6.666，95% CI 2.402~18.498)以及工具性日常生活重度依赖(OR=4.354，95% CI 1.892~10.019)均是住院老年高血压合并糖尿病患者衰弱发生的危险因素(P＜0.05)。结论：老年高血压合并糖尿病患者衰弱发生较为常见,医护人员应高度重视对该人群衰弱的评估,及时采取针对性的整体干预措施,预防或减缓老年高血压合并糖尿病患者衰弱的发生发展。

[1] 中华医学会老年医学分会,《中华老年医学杂志》编辑委员会.老年人衰弱预防中国专家共识(2022)[J].中华老年医学杂志,2022,41(5):503-511.
[2] IDA S,KANEKO R,IMATAKA K,et al.Relationship between frailty and mortality,hospitalization,and cardiovascular diseases in diabetes:a systematic review and meta-analysis[J].Cardiovasc Diabetol,2019,18(1):1-13.
[3] APRAHAMIAN I,SASSAKI E,DOS SANTOS M F,et al.Hypertension and frailty in older adults[J].J Clin Hypertens,2018,20(1):186-192.
[4] CASTREJÓN-PÉREZ R C,GUTIERREZ-ROBLEDO L M,CESARI M,et al.Diabetes mellitus,hypertension and frailty:a population-based,cross-sectional study of Mexican older adults[J].Geriatr Gerontol Int,2017,17(6):925-930.
[5] MA L,ZHANG L,SUN F,et al.Frailty in Chinese older adults with hypertension:prevalence,associated factors,and prediction for long-term mortality[J].J Clin Hypertens,2018,20(11):1595-1602.
[6] SINCLIAR A J,RODRIGUEZ-MANAS L.Diabetes and frailty:two converging conditions?[J].Can J Diabetes,2016,40(1):77-83.
[7] 刘真秀,董铭,林立文,等.《中国老年高血压管理指南2019》解读[J].长春中医药大学学报,2020,36(5):1076-1079.
[8] 国家老年医学中心,中华医学会老年医学分会,中国老年保健协会糖尿病专业委员会.《中国老年糖尿病诊疗指南(2021年版)》专家解读[M].北京:人民卫生出版社,2022:14.
[9] DENT E,MORLEY J E,CRUZ-JENTOFT A J,et al.Physical frailty:ICFSR international clinical practice guidelines for identification and management[J].J Nutr Health Aging,2019,23:771-787.
[10] 郝秋奎,李峻,董碧蓉,等.老年患者衰弱评估与干预中国专家共识[J].中华老年医学杂志,2017,36(3):251-256.
[11] 唐丹.简版老年抑郁量表(GDS-15)在中国老年人中的使用[J].中国临床心理学杂志,2013,21(3):402-405.
[12] DURMAZ B,SOYSAL P,ELLIDOKUZ H,et al.Validity and reliability of geriatric depression scale-15(short form) in Turkish older adults[J].North Clin Istanb,2018,5(3):216-220.
[13] 王征宇,迟玉芬.焦虑自评量表(SAS)[J].上海精神医学,1984(2):73-74.
[14] 乔艳阳,王健,张春雨.焦虑自评量表在公务员群体中的信效度检验及区域性常模的制定[J].心理学进展,2022,12(6):2269-2278.
[15] 周小炫.中文版简易智能精神状态检查量表在脑卒中患者中的信效度初步研究[D].福州：福建中医药大学,2016.
[16] FOLSTEIN M F.A practical method for grading the cognitive state of patients for the clinician[J].J Psychiatr Res,1975,12(3):189-198.
[17] CHEN L K,WOO J,ASSANTACHAI P,et al.Asian Working Group for Sarcopenia:2019 consensus update on sarcopenia diagnosis and treatment[J].J Am Med Dir Assoc,2020,21(3):300-307.
[18] GOMEZ J F,CURCIO C L,ALVARADO B,et al.Validity and reliability of the Short Physical Performance Battery(SPPB):a pilot study on mobility in the Colombian Andes[J].Colomb Med(Cali),2013,44(3):165-171.
[19] WELCH S A,WARD R E,BEAUCHAMP M K,et al.The Short Physical Performance Battery(SPPB):a quick and useful tool for fall risk stratification among older primary care patients[J].J Am Med Dir Assoc,2021,22(8):1646-1651.
[20] KATZ S,DOWNS T D,CASH H R,et al.Progress in development of the index of ADL[J].Gerontologist,1970,10(1):20-30.
[21] LAWTON M P,BRODY E M.Assessment of older people:self-maintaining and instrumental activities of daily living[J].Gerontologist,1969,9(3):179-186.
[22] ISIK E I,YILMAZ S,UYSAL I,et al.Adaptation of the Lawton instrumental activities of daily living scale to Turkish:validity and reliability study[J].Ann Geriatr Med Res,2020,24(1):35-40.
[23] CARMONA-TORRES J M,RODRIGUEZ-BORREGO M A,LAREDO-AGUILERA J A,et al.Disability for basic and instrumental activities of daily living in older individuals[J].PLoS One,2019,14(7):e0220157.
[24] 刘墩秀,丁福,朱跃平,等.汉化版Morse跌倒评估量表和Hendrich Ⅱ跌倒因素模型量表在老年住院患者跌倒风险评估中的适用性比较[J].中国护理管理,2020,20(8):1168-1172.
[25] CHOW S K,LAI C K,WONG T K,et al.Evaluation of the Morse Fall Scale:applicability in Chinese hospital populations[J].Int J Nurs Stud,2007,44(4):556-565.
[26] PODISADLO D,RICHARDSON S.The timed “Up & Go”:a test of basic functional mobility for frail elderly persons[J].J Am Geriatr Soc,1991,39(2):142-148.
[27] 毛维武,扈玫琳,张婷婷,等.老年高血压和糖尿病患者健康素养、社会支持、抑郁及衰弱的关系研究[J].中国卫生统计,2023,40(2):246-248.
[28] CESARI M,CALVANI R,MARZETTI E.Frailty in older persons[J].Clin Geriatr Med,2017,33(3):293-303.
[29] FERRANNINI E,CUSHMAN W C.Diabetes and hypertension:the bad companions[J].Lancet,2012,380(9841):601-610.
[30] NISHIKAWA H,FUKUNISHI S,ASAI A,et al.Sarcopenia,frailty and type 2 diabetes mellitus[J].Mol Med Rep,2021,24(6):854.
[31] 杨光,吴云涛,阮晓兰,等.糖尿病、高血压人群心脑血管事件的发生情况及影响因素[J].中华高血压杂志,2014,22(12):1132-1138.
[32] PAULSON D,LICHTENBERG P A.Vascular depression:an early warning sign of frailty[J].Aging Ment Health,2013,17(1):85-93.
[33] DEOOING M S,KOHLER-IPEK L,ULLRICH P,et al.Depression im Alter und Frailty-epidemiologische,klinische und neurobiologische Zusammenhänge[J].Nervenarzt,2023,94(3):234-239.
[34] 侯苹,薛慧萍,吴琳凤,等.老年人衰弱影响因素的Meta分析[J].中国老年学杂志,2019,39(6):1385-1389.
[35] TORNERO-QUIÑONES I,SÁEZ-PADILLA J,ESPINA DIAZ A,et al.Functional ability,frailty and risk of falls in the elderly:Relations with autonomy in daily living[J].Int J Environ Res Public Health,2020,17(3):1006.
[36] KOJIMA G.Frailty as a predictor of disabilities among community-dwelling older people:a systematic review and meta-analysis[J].Disabil Rehabil,2017,39(19):1897-1908.
[37] GUO L,AN L,LUO F,et al.Social isolation,loneliness and functional disability in Chinese older women and men:a longitudinal study[J].Age Ageing,2021,50(4):1222-1228.
[38] WANG H,CHEN K,PAN Y,et al.Associations and impact factors between living arrangements and functional disability among older Chinese adults[J].PLoS One,2013,8(1):e53879.
[39] RAMIREZ-VEELEZ R,DE ASTEASU M L S,MORLEY J E,et al.Performance of the short physical performance battery in identifying the frailty phenotype and predicting geriatric syndromes in community-dwelling elderly[J].J Nutr Health Aging,2021,25(2):209-217.
[40] 郑燕蓉,林莉,毛月.老年慢病共病人群中肌肉减少症患病情况研究[J].现代医学,2022,50(5):618-623.
[41] 武力,郑燕蓉,柴源.老年住院患者衰弱程度与肌肉减少症严重程度的相关性分析[J].现代医学,2020,48(5):647-651.
[42] CRUZ-JENTOFT A J,KIESSWETTER E,DREY M,et al.Nutrition,frailty,and sarcopenia[J].Aging Clin Exp Res,2017,29(1):43-48.
[43] 杨璇璇,蒋昕,马萱,等.社区老年人肌少症与认知功能和体力活动的相关性研究[J].现代医学,2023,51(8):1096-1103.
[44] 张爽,陈影,孙娜雅,等.综合运动训练对老年糖尿病患者衰弱和躯体功能的影响[J].中华护理杂志,2020,55(10):1445-1451.
[45] 郭雅乐,李军文,王兆兰,等.中国住院老年病人衰弱现状及影响因素的Meta分析[J].全科护理,2023,21(29):4045-4050.
[46] 廖春霞,马红梅,徐旭,等.中国社区老年人衰弱发生率的meta分析[J].职业与健康,2017,33(20):2767-2770.
[47] 刘云,魏利荣,刘晓凤,等.我国养老机构老年人衰弱患病率meta分析[J].职业与健康,2022,38(22):3120-3124，3128.
[48] LIU Y,MENG H,TU N,et al.The relationship between health literacy,social support,depression,and frailty among community-dwelling older patients with hypertension and diabetes in China[J].Front Public Health,2020,8:280.