A pilot study to identify factors associated with frailty within the World Trade Center general responder cohort

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH American journal of industrial medicine Pub Date : 2024-05-12 DOI:10.1002/ajim.23590

Hannah M. Thompson MD, MPH, Erin Thanik MD, MPH, Ahmad Sabra MS, MPH, Fred Ko MD, William W. Hung MD, MPH, Elena Colicino PhD, Roberto G. Lucchini MD, Ghalib Bello PhD, Michael Crane MD, MPH, Susan L. Teitelbaum PhD, Katherine A. Ornstein PhD, MPH

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Abstract

Background

Given the significant exposures experienced by the World Trade Center (WTC) general responders, there is increasing interest in understanding the effect of these exposures on aging in this population. We aim to identify factors that may be associated with frailty, a clinical syndrome characterized by a decrease in one's reserve that has been linked to poor health outcomes.

Methods

WTC general responders enrolled in the WTC Health Program aged 50 and older provided informed consent. Validated frailty assessments, the Frailty Phenotype (with the Johns Hopkins Frailty Assessment Calculator) along with the FRAIL scale, categorized nonfrail from prefrail/frail. Fall risk, functional status, and cognition were also assessed. WTC variables, including an identified WTC-certified condition, were utilized. The risk of frailty was estimated using log binomial regression analysis. A 95% confidence interval (CI) was used to estimate the prevalence ratio (PR).

Results

One hundred and six participants were included; 38 (35.8%) were classified as pre-frail or frail. More of the pre-frail/frail group were obese (57.9% vs. 25%; p = 0.004) and had a WTC-certified condition (78.9% vs. 58.8%; p = 0.036). Obesity (PR = 2.43, 95% CI = 1.31, 4.53), a WTC-certified condition (PR = 1.77, 95% CI = 1.09, 2.89), and risk of falling (PR = 1.97, 95% CI = 1.01, 3.84) were independently associated with frailty.

Conclusions

Obesity and having a WTC-certified condition were found to be risk factors for frailty in our pilot study. Future work may focus on further identifying risk factors for frailty in the larger WTC general responder population.

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一项试点研究，旨在确定世贸中心一般响应者队列中与虚弱有关的因素。

背景：鉴于世界贸易中心（WTC）的一般响应者所经历的重大暴露，人们越来越有兴趣了解这些暴露对这一人群衰老的影响。虚弱是一种临床综合症，其特点是储备能力下降，与不良的健康状况有关：方法：参加永利国际娱乐健康计划的 50 岁及以上的永利国际娱乐普通响应者均已知情同意。经过验证的虚弱评估、虚弱表型（使用约翰-霍普金斯大学虚弱评估计算器）和 FRAIL 量表将非虚弱与预虚弱/虚弱进行了分类。此外，还对跌倒风险、功能状态和认知能力进行了评估。此外，还使用了 WTC 变量，包括已确定的 WTC 认证条件。虚弱风险采用对数二项式回归分析法进行估算。使用 95% 置信区间 (CI) 估算患病率比 (PR)：共纳入了 16 名参与者，其中 38 人（35.8%）被归类为前期虚弱或体弱。在前期衰弱/虚弱组中，肥胖者（57.9% 对 25%；P = 0.004）和患有永利国际娱乐认证疾病者（78.9% 对 58.8%；P = 0.036）更多。肥胖（PR = 2.43，95% CI = 1.31，4.53）、有 WTC 证书（PR = 1.77，95% CI = 1.09，2.89）和跌倒风险（PR = 1.97，95% CI = 1.01，3.84）与体弱独立相关：结论：在我们的试点研究中发现，肥胖和患有经 WTC 认证的疾病是导致虚弱的风险因素。未来的工作重点可能是在更大的永利国际娱乐平台一般反应人群中进一步确定导致虚弱的风险因素。

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来源期刊

American journal of industrial medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.90

自引率

5.70%

发文量

108

审稿时长

4-8 weeks

期刊介绍： American Journal of Industrial Medicine considers for publication reports of original research, review articles, instructive case reports, and analyses of policy in the fields of occupational and environmental health and safety. The Journal also accepts commentaries, book reviews and letters of comment and criticism. The goals of the journal are to advance and disseminate knowledge, promote research and foster the prevention of disease and injury. Specific topics of interest include: occupational disease; environmental disease; pesticides; cancer; occupational epidemiology; environmental epidemiology; disease surveillance systems; ergonomics; dust diseases; lead poisoning; neurotoxicology; endocrine disruptors.