Analysis Of Correlation And Influencing Factors Between Frailty In Old Age And TCM Constitution

Objective: This study intends to analyze the relationship between TCM constitution and senile frailty and further explore the related influencing factors of constitution and frailty to provide a basis for clinical prevention and intervention of senile frailty.Methods: A cross-sectional study was used in this study.From January1,2022 to February 1,2023,a total of 53 elderly people over 60 years old in the pre-frailty stage and 229 elderly people in the frailty stage were hospitalized or outpatient in the Cadre Health Department of the Second Affiliated Hospital of Shandong University of Chinese Medicine,Jinan Yinfeng Villa Apartment for the Elderly,Huaiyin District Elderly Care Service Center,Wuzhai Village,Zhongwei Township,Yicheng County,Linfen City,Shanxi Province were collected.The basic information collection table,Fried Frailness Assessment Scale,Wang Qi Traditional Chinese Medicine Physique Scale,Daily Living Ability Scale(ADL),MINI Nutrition Assessment Scale(MNA),depression CES-D scale,osteoporosis risk self-assessment scale,simple Mc Gill Pain Questionnaire(SF-MPQ),sleep disorder Assessment Scale(Assens loss)were used Sleep scale),Morse Fall Assessment Scale(MFS)and EAT-10 swallowing score scale were used to collect relevant information of participants.Correlation analysis and regression analysis were used to analyze the correlation between each factor and frailty and TCM constitution to explore the relevant influencing factors of frailty.Results:1.The relationship between frailty and TCM constitution: A total of 282 participants were included,including 53 at the early stage of frailty and229 at the stage of frailty.In the early asthenia period,45.28% of the population had the peaceful constitution,while in the asthenia period,6.99% of the population had the peaceful constitution.There were significant differences in the peaceful constitution and biased constitution(Yang deficiency,Yin deficiency,qi deficiency,damp-heat quality,blood stasis quality,qi stagnation quality)between the people in the early and the weak stage,and the differences were statistically significant(P < 0.05).Correlation analysis showed that frailty was significantly correlated with the peaceful constitution and biased constitution(Yang deficiency,Yin deficiency,qi deficiency,blood stasis and qi stagnation)(P<0.05).2.Analysis of influencing factors of frailty: univariate analysis showed that frailty was significantly correlated with age,gentleness constitution,Whether the spouse is alive,type of medical insurance,history of smoking and drinking,pain,hypertension,diabetes,coronary heart disease,gait disorder,visual impairment,and long-term medication history(P<0.05).Factors significantly related to frailty in univariate analysis were included in binary logistic regression analysis,and it was found that ADL score,no spouse/divorced or widowed,and pain were significant risk factors for frailty,and employee medical insurance was relative to resident medical insurance,and peaceful constitution was relative to biased constitution were the protective factors of frailty.ROC curve was drawn according to the regression results.The area under the curve was 0.931(95%CI: 0.888-0.975;P < 0.001).The optimal cut-off value was0.731(sensitivity 88.2%,specificity 84.9%).3.Analysis of influencing factors of peace Constitution: Unifactor correlation analysis between peace constitution and various factors showed that age,EAT-10 score,CES-D score,ADL score,sleep disorder,limb muscle strength,MFS score,pain,limb numbness,gait disorder,digestive system disease,fall risk,hypertension,coronary heart disease,number of chronic diseases,long-term medication history were significantly correlated with peace constitution(P<0.05).Multivariate logistic regression analysis of factors related to peace constitution found that no pain,no long-term medication history and no sleep disorder were more inclined to peace constitution,which were protective factors for peace constitution.The ROC curve was drawn according to the regression model,and the area under the curve was 0.828(95%CI: 0.760-0.897;P<0.001);The optimal cut-off value was 0.560(sensitivity 80.0%,specificity 76.0%).4.Analysis of influencing factors of each biased constitution: The multiple linear regression model of influencing factors of biased constitution found that EAT-10 score,pain score,CES-D score and digestive system disease were linearly positively correlated with blood stasis constitution score;The score of ADL,hypertension and digestive diseases were positively correlated with the score of Yang deficiency constitution,while the score of lower limb muscle strength was linearly negatively correlated with the score of Yang deficiency substance.There was a linear positive correlation between sleep disorder,coronary heart disease and Yin deficiency constitution score,while there was linearly negative correlation between education and Yin deficiency constitution score.There was a positive linear correlation between sleeping disorder and taking diuretics and Qi-depression body score,and there was linearly negative correlation between lower limb muscle strength and Qi-depression body score.A positive linear correlation existed between the ADL score and the Qi-deficiency constitution score.5.This study found that pain significantly impacts frailty and physical fitness,which is significantly related to frailty.In order to explore whether physical fitness plays a certain role in the effect of pain on frailty,the mediation effect model was used in this study to analyze and find that physical fitness partially mediates the effect of pain on frailty(contribution rate: 25.73%).Conclusion: This study found that frailty is a complex organism states mediated by multiple factors,among which ADL score,no spouse/divorce widowed,pain,type of health insurance,and peace constitution have significant effects on frailty.Pain,long-term medication history,and sleep disorders significantly impact the peace constitution.Finally,the mediation effect model is used to find that physical fitness may play an important role in the influence of pain on frailty.Therefore,more in-depth prospective cohort studies are needed to analyze the influence of pain and physical fitness on frailty in the future.