老年人群隐匿性衰弱的风险识别与个体化护理策略

Risk Identification and Individualized Nursing Strategies for Latent Frailty in the Elderly Population

摘要: 随着全球人口老龄化的加剧，隐匿性衰弱作为老年人群介于健康与失能之间的亚临床状态，因症状隐匿易被误判为自然老化，导致干预延误，已成为老年医学与公共卫生领域的重点议题。其由生物–心理–社会多维度因素交互引发，包括慢性疾病累积、营养不良、体力活动不足、抑郁情绪及社会支持缺失等，显著增加老年个体失能、住院及死亡风险，加重医疗照护负担。本研究通过文献综述法与实证分析法，系统梳理隐匿性衰弱的理论基础、核心特征及发展机制，结合典型案例剖析其表现形式与影响路径，明确女性、低教育水平及社会孤立群体为高危人群，规律中高强度体力活动、良好睡眠质量与健全社会支持具保护效应。同时发现，基于累积缺陷模型的衰弱指数(FI)和Fried衰弱表型等评估工具预测价值较高，但基层标准化应用不足。研究提出构建“生理指标 + 心理评估 + 社会功能”的动态预警体系，倡导以多组分运动、营养干预和心理支持为核心的跨学科个体化护理模式，为老年健康管理从“疾病治疗”向“功能维护”转型提供依据，对推进健康老龄化、优化医疗资源配置具有重要意义。

Abstract: With the intensification of global population aging, latent frailty, as a subclinical state between health and disability among the elderly, is easily misjudged as natural aging due to its concealed symptoms, leading to delayed intervention. It has become a key issue in the fields of geriatrics and public health. It is triggered by the interaction of multi-dimensional factors such as biological, psychological and social ones, including the accumulation of chronic diseases, malnutrition, insufficient physical activity, depressive mood and lack of social support, significantly increasing the risk of disability, hospitalization and death in elderly individuals, and adding to the burden of medical care. This study, through literature review and empirical analysis methods, systematically sorts out the theoretical basis, core characteristics and development mechanism of latent frailty. It analyzes its manifestations and influence paths in combination with typical cases, and clarifies that women, those with low education levels and socially isolated groups are high-risk groups. Regular moderate to high-intensity physical activity, good sleep quality and sound social support have protective effects. It was also found that assessment tools such as the frailty index (FI) based on the cumulative defect model and the Fried frailty phenotype have relatively high predictive value, but their standardized application at the grassroots level is insufficient. The research proposes to build a dynamic early warning system of “physiological indicators + psychological assessment + social functions”, and advocates a cross-disciplinary individualized nursing model centered on multi-component exercise, nutritional intervention and psychological support, providing a basis for the transformation of elderly health management from “disease treatment” to “function maintenance”, which is of great significance for promoting healthy aging and optimizing the allocation of medical resources.