中文版老年人多维衰弱评估工具的系统评价

doi:10.3761/j.issn.0254-1769.2025.24.016

摘要/Abstract

摘要：

目的系统评价中文版老年人多维衰弱评估工具，为医护人员选择适宜的工具提供参考。方法系统检索PubMed、Web of Science、Embase、Cochrane Library、CINAHL、Medline、中国知网、万方数据库和中国生物医学文献服务系统，检索时限为建库至2025年5月21日。依据共识驱动的健康测量工具选择标准指南系统评价纳入的评估工具，并生成推荐意见。结果共纳入22项研究，涉及17种中文版老年人多维衰弱评估工具。其中，老年人衰弱指数量表的内容效度和内部一致性较好，为A级推荐，其余评估工具均为B级或C级推荐。结论中文版老年人多维衰弱评估工具较多，多数评估工具的方法学质量和测量学属性存在一定问题，暂推荐使用老年人衰弱指数量表，但选择时仍需结合具体的临床情境。

关键词: 老年人, 多维衰弱, 评估工具, 系统评价, 护理

Abstract:

Objective To systematically evaluate assessment tools of the Chinese version for multi-dimensional frailty and to provide a reference to select appropriate tools. Methods PubMed，Web of Science，Embase，Cochrane Library，CINAHL，Medline，CNKI，Wanfang Database，and China Biomedical Literature Database were searched from inception to May 21，2025. The included studies were evaluated using the consensus-driven standards for the selection of health measurement instrument guidelines to generate recommendations. Results A total of 22 studies were included，involving 17 Chinese version assessment tools for measuring multi-dimensional frailty. Among them，the content validity and internal consistency of the Index of Frailty Scale for Older Adults were good，and it was recommended at level A. The rest were recommended at level B or C. Conclusion The Chinese versions of multi-dimensional frailty assessment tools are diverse，and most demonstrate methodological and psychometric limitations. The Index of Frailty Scale for Older Adults is provisionally recommended，but its use should depend on specific clinical contexts.

Key words: Aged, Multi-Dimensional Frailty, Assessment Tools, Systematic Review, Nursing Care

吴燕, 陈管洁, 吴燕平, 孙惠, 顾玥. 中文版老年人多维衰弱评估工具的系统评价[J]. 中华护理杂志, 2025, 60(24): 3045-3051.

WU Yan, CHEN Guanjie, WU Yanping, SUN Hui, GU Yue. Chinese version of the assessment tools for multi-dimensional frailty：a systematic review[J]. Chinese Journal of Nursing, 2025, 60(24): 3045-3051.

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参考文献 37

[1]	国家卫生健康委. 关于印发“十四五”健康老龄化规划的通知[J]. 中华人民共和国国家卫生健康委员会公报, 2022(2):16-25.
	National Health Commission. Circular on issuing the healthy aging plan during the 14th Five-Year Plan period[J]. Gaz Natl Health Comm People’s Repub China, 2022(2):16-25.
[2]	Liu W, Qin RX, Qiu YM, et al. Multidimensional frailty as a predictor of mortality among older adults:a systematic review and meta-analysis[J]. BMC Geriatr, 2024, 24(1):793. DOI
[3]	Pilotto A, Custodero C, Maggi S, et al. A multidimensional ap-proach to frailty in older people[J]. Ageing Res Rev, 2020, 60:101047. DOI URL
[4]	Zhu P, Mei DM, Yang Y, et al. Prevalence and determinants of multidimensional frailty in hospitalized older adults with coro-nary heart disease:a LASSO regression analysis[J]. Front Car-diovasc Med, 2025, 12:1588288.
[5]	Qiu YM, Li GC, Wang XX, et al. Prevalence of multidimensio-nal frailty among community-dwelling older adults:a systematic review and meta-analysis[J]. Int J Nurs Stud, 2024, 154:104755. DOI URL
[6]	赵琳琳, 罗琪, 胡清华, 等. 社区老年人多维衰弱研究进展[J]. 中国全科医学, 2025, 28(10):1281-1288. DOI
	Zhao LL, Luo Q, Hu QH, et al. Research on the multidimen-sional frailty in community-dwelling older adults[J]. Chin Gen Pract, 2025, 28(10):1281-1288.
[7]	Vergara I, Mateo-Abad M, Saucedo-Figueredo MC, et al. Descri-ption of frail older people profiles according to four screening tools applied in primary care settings:a cross sectional analy-sis[J]. BMC Geriatr, 2019, 19(1):342. DOI PMID
[8]	王世强, 郭凯林, 李丹, 等. 身体活动水平对中国老年人衰弱的影响:基于中国健康与养老追踪调查的多期数据研究[J]. 陕西师范大学学报(自然科学版), 2023, 51(5):91-103. DOI
	Wang SQ, Guo KL, Li D, et al. Effects of physical activity levels on frailty of older Chinese people:a multi-period data study based on the China health and retirement longitudinal study[J]. J Shaanxi Norm Univ Nat Sci Ed, 2023, 51(5):91-103.
[9]	Mokkink LB, Elsman EBM, Terwee CB. COSMIN guideline for systematic reviews of patient-reported outcome measures version 2.0[J]. Qual Life Res, 2024, 33(11):2929-2939. DOI
[10]	陈祎婷, 沈蓝君, 彭健, 等. 改良版定量系统评价证据分级方法对患者报告结局测量工具的评价[J]. 解放军护理杂志, 2020, 37(10):57-60.
	Chen YT, Shen LJ, Peng J, et al. Modified GRADE evaluation of COSMIN method for patient reported outcome measures[J]. Nurs J Chin PLA, 2020, 37(10):57-60.
[11]	Kang LJ, Naude A, Rocha A, et al. An international systematic review of the ICF in education:cross-language comparisons from Chinese,German,Italian,and Portuguese publications[J]. Front Educ, 2025, 10:1526194. DOI URL
[12]	彭颖洁, 刘艾红, 朱文莉, 等. 老年人预立医疗照护计划准备度评估工具的系统评价[J]. 中华护理杂志, 2025, 60(9):1146-1153. DOI URL
	Peng YJ, Liu AH, Zhu WL, et al. Systematic review of readi-ness assessment tools for advance care planning in older adults[J]. Chin J Nurs, 2025, 60(9):1146-1153.
[13]	Terwee CB, Prinsen CC, Chiarotto A, et al. COSMIN methodo-logy for evaluating the content validity of patient-reported outcome measures:a Delphi study[J]. Qual Life Res, 2018, 27(5):1159-1170. DOI PMID
[14]	李菲, 刘慧松, 查龙肖, 等. 中文版老年人衰弱评估量表的修订和信效度评价[J]. 护理学杂志, 2017, 32(7):18-20,27.
	Li F, Liu HS, Zha LX, et al. Reliability and validity testing of the Chinese version of Tiburg Frailty Indicator[J]. J Nurs Sci, 2017, 32(7):18-20,27.
[15]	关欣, 黄飞, 闫小光, 等. 《中西医结合老年衰弱评估量表》的构建研究[J]. 北京中医药, 2018, 37(3):202-205,211.
	Guan X, Huang F, Yan XG, et al. Study on the establishment of Elderly Frailty Assessment Scale of Integrative Medicine[J]. Beijing J Tradit Chin Med, 2018, 37(3):202-205,211.
[16]	黄韵芝, 林清. 格罗宁根衰弱指标的汉化研究[J]. 护理学报, 2019, 26(18):1-5. DOI
	Huang YZ, Lin Q. Translation study of Groningen Frailty Indi-cator[J]. J Nurs(China), 2019, 26(18):1-5.
[17]	杨丽峰, 杨洋, 张春梅, 等. 老年人衰弱评估量表的编制及信效度检验[J]. 中华护理杂志, 2017, 52(1):49-53.
	Yang LF, Yang Y, Zhang CM, et al. Development and reliabi-lity and validity tests of Elderly Frailty Assessment Scale[J]. Chin J Nurs, 2017, 52(1):49-53.
[18]	王坤, 陈长香, 李淑杏. 衰弱综合评估工具的汉化及信效度检验[J]. 中国康复理论与实践, 2017, 23(1):72-76. DOI
	Wang K, Chen CX, Li SX. Reliability and validity of Chinese version of Comprehensive Frailty Assessment Instrument[J]. Chin J Rehabil Theory Pract, 2017, 23(1):72-76.
[19]	乔玉凤, 刘学军, 杜毓锋, 等. 基于照护者的老年综合评估衰弱指数问卷的汉化及信效度检验[J]. 中华老年病研究电子杂志, 2016, 3(3):16-23.
	Qiao YF, Liu XJ, Du YF, et al. Chinesization and validation of a Care Partner-Frailty Index-Comprehensive Geriatric Assess-ment Questionnaire[J]. Chin J Geriatr Res Electron Ed, 2016, 3(3):16-23.
[20]	奚兴, 郭桂芳, 孙静. 中文版Tilburg衰弱评估量表的信效度研究[J]. 护理学报, 2013, 20(16):1-5.
	Xi X, Guo GF, Sun J. Reliability and validity of Chinese version of Tilburg Frailty Indicator[J]. J Nurs(China), 2013, 20(16):1-5.
[21]	郭欣颖, 郝莹, 张宇, 等. 中文版Edmonton衰弱评估量表在住院老年病人中的信效度研究[J]. 实用老年医学, 2022, 36(6):623-626,631.
	Guo XY, Hao Y, Zhang Y, et al. Reliability and validity of the Chinese version of Edmonton Frailty Scale for Chinese elderly inpatients[J]. Pract Geriatr, 2022, 36(6):623-626,631.
[22]	牛娟娟, 石美霞, 张绍果, 等. 老年住院病人衰弱评估量表的研制及信效度检验[J]. 护理研究, 2022, 36(3):402-407.
	Niu JJ, Shi MX, Zhang SG, et al. Development and testing of validity and reliability on Frailty Assessment Scale for Elderly Inpatients[J]. Chin Nurs Res, 2022, 36(3):402-407.
[23]	张琴, 於茗, 肖明兵, 等. 简版老年综合评估问卷的汉化及在癌症患者中的信效度研究[J]. 中华现代护理杂志, 2023, 29(29):3978-3984.
	Zhang Q, Yu M, Xiao MB, et al. Chinese version of the Abbre-viated Comprehensive Geriatric Assessment and its reliability and validity in cancer patients[J]. Chin J Mod Nurs, 2023, 29(29):3978-3984.
[24]	梁亚萍. 老年人衰弱指数量表的研制及初步应用研究[D]. 湛江: 广东医科大学, 2018.
	Liang YP. Development and preliminary application of Frailty Index[D]. Zhangjiang: Guangdong Medical University, 2018.
[25]	张宇辉. 社区老年衰弱筛查量表的建立与初步验证[D]. 成都: 四川大学, 2021.
	Zhang YH. Establishment and preliminary verification of Screening Scale for Senile Weakness in Community[D]. Cheng-du: Sichuan University, 2021.
[26]	包新茹. 综合衰弱评估量表修订版CFAI-Plus的汉化及预测社区衰弱老年人不良结局的应用研究[D]. 成都: 成都中医药大学, 2020.
	Bao XR. The sinicization of the revised Comprehensive Weakness Assessment Scale CFAI-plus and its application in predicting the adverse outcome of the weakness elderly in the community[D]. Chengdu: Chengdu University of TCM, 2020.
[27]	夏宇晓, 钟慧仪, 周英, 等. 老年人衰弱评估量表的心理测量属性评价[J]. 循证护理, 2021, 7(14):1937-1941.
	Xia YX, Zhong HY, Zhou Y, et al. Evaluation of psychometric attributes of Chinese Frailty Indicator Scale[J]. Chin Evid Based Nurs, 2021, 7(14):1937-1941.
[28]	Qiao XX, Wang CL, Tian XY, et al. Cross-cultural adaptation and validation of the Comprehensive Frailty Assessment Instru-ment in Chinese community-dwelling older adults[J]. Geriatr Gerontol Int, 2018, 18(2):301-307. DOI URL
[29]	Tian XY, Qiao XX, Dong LJ, et al. Cross-cultural adaptation and psychometric properties of the Groningen Frailty Indicator(GFI) among Chinese community-dwelling older adults[J]. Ge-riatr Nurs, 2020, 41(3):236-241.
[30]	Dong LJ, Liu N, Tian XY, et al. Reliability and validity of the Tilburg Frailty Indicator(TFI) among Chinese community-dwe-lling older people[J]. Arch Gerontol Geriatr, 2017, 73:21-28. DOI URL
[31]	Ye B, Wang Y, Chen H, et al. Development and validation of the Chinese Frailty Screening Scale:a study among com-munity-dwelling older adults in Shanghai[J]. Int J Environ Res Public Health, 2022, 19(18):11811. DOI URL
[32]	Yeung MT, Gan Y, Teo SQ, et al. The Chinese translation and cross-cultural adaptation of PRISMA-7 questionnaire:an ob-servational study to establish the accuracy,reliability and validity[J]. BMC Geriatr, 2024, 24(1):204. DOI
[33]	Huang EYZ, Cheung J, Liu JYW, et al. Groningen Frailty Indi-cator Chinese(GFI-C) for pre-frailty and frailty assessment among older people living in communities:psychometric pro-perties and diagnostic accuracy[J]. BMC Geriatr, 2022, 22(1):788. DOI PMID
[34]	Wang Q, Tao A, Zhang Y, et al. Psychometric properties of the simplified Chinese version of Kihon Checklist in the Chinese older people[J]. Int J Older People Nurs, 2023, 18(2):e12524. DOI URL
[35]	Bai DX, Liang Y, Wu CX, et al. Reliability and validity of the Chinese version of the Trauma-Specific Frailty Index(TSFI) for geriatric trauma patients[J]. BMC Geriatr, 2023, 23(1):617. DOI
[36]	彭健, 沈蓝君, 陈祎婷, 等. 对COSMIN-RoB清单中测量工具稳定性、测量误差和效标效度研究偏倚风险的清单解读[J]. 中国循证医学杂志, 2020, 20(11):1340-1344.
	Peng J, Shen LJ, Chen YT, et al. Interpretation of COSMIN risk of bias checklist in evaluating risk of bias of studies on reliability,measurement error and criteria validity of patient-reported outcome measures[J]. Chin J Evid Based Med, 2020, 20(11):1340-1344.
[37]	冯静宜, 张雪芳, 周雪迎, 等. 老年衰弱患者真实体验质性研究的Meta整合[J]. 中华护理杂志, 2023, 58(23):2928-2935. DOI URL
	Feng JY, Zhang XF, Zhou XY, et al. The real experience of frailty in elderly patients:a qualitative Meta-synthesis[J]. Chin J Nurs, 2023, 58(23):2928-2935.