Study On The Relationship Between Frailty And Quality Of Life And Frailty Trajectory In Community Elderly Patients With Moderate And Severe Hypertension

Objective: This study aims to investigate the current situation of frailty,ability of daily life,depression,social support and quality of life among elderly patients with moderate and severe hypertension in the community,to analysis the influencing factors of frailty,to explore the relationship among frailty,activity of daily living,depression,social support and quality of life,to describe the frailty trajectories of a year,to analysis the effect of the frailty development trajectory on changes in quality of life and analysis the influencing factors of frailty trajectories.Methods: From January to December,2021,elderly patients with moderate and severe hypertension in four community of Nanning were selected to conduct questionnaires on general demographic,TFI,ADL,GDS-5,social support and SF-12 scale.The differences of frailty among different demographic data,physiological,psychological and social aspects were analyzed by independent sample t test or chi-square test.The influence factors of frailty were analyzed by means of multiple logistic regression.Spearman correlation analysis was used to analyze the correlation between variables.Structural equation model was further used to analyze the relationship between frailty and other variables.Group-based trajectory modeling(GBTM)was used to describe trajectories of frailty.Polynomial logistic regression was used to analysis main factors influencing the attribution of the frailty trajectory among elderly patients with moderate and severe hypertension in the community.Results: The prevalence of frailty was 42.5% among elderly patients with moderate and severe hypertension in the community.The prevalence of depression was 29.5% among elderly patients with moderate and severe hypertension in the community.The average score of ADL among participants was(96.68±3.82).The average score of social support was(34.86±5.64).The average score of PCS among participants was(54.68±1.10).The average score of MCS among participants was(59.54 ± 1.26).Multiple logistic regression analysis showed that age(OR=1.396),hypertension disease course(OR=127.636),comorbidity(OR=61.535),ADL(OR=0.67),depression(OR=9.705)were influencing factors of frailty.Correlation analysis showed that frailty of elderly patients with moderate and severe hypertension in the community was negatively correlated with ADL,social support,PCS and MCS(r =-0.517,-0.428,-0.659,-0.382,P<0.05),positively correlated with depression(r =0.573,P<0.05).Further analysis by the structural equation model showed that the effect path coefficients of ADL,depression,and social support to frailty were-0.247,0.551,-0.195,respectively.And the effect path coefficients of frailty to PCS and MCS were-0.877,-0.852 respectively.Group-based trajectory modeling analysis showed that there were four different frailty development trajectory models,namely “low-stable model”,“low start,rapidly increasing model”,“medium start,rapidly increasing model”,“high start,slowly increasing model”.Polynomial logistic regression analysis showed that age,nation,grade 3 hypertension,course of hypertension,comorbidity,ADL,depression were factors influencing the attribution of the frailty trajectory among elderly patients with moderate and severe hypertension in the community.Conclusion: It is not optimistic that the prevalence of frailty was high,the status of depression was weak,the level of social support was low and the quality of life was bad.The level of ability of daily life were moderate.Frailty issue which were influenced by age,hypertension disease course,comorbidity,ADL and depression should be paid attention.ADL,depression,and social support this three variables all had effects on frailty,and depression had the largest effect.We can improve the frail status of elderly by solving depression issue.Most of the participants’ frailty development trajectory were attributed the “low-stable model”.Course of hypertension was > 10 years and comorbidity were the main influencing factors of frailty development trajectory.We can slow down the development of frailty by intervening the Course of hypertension and comorbidity.