Changes in biological markers of health: Older Americans in the 1990s
Changes in biological markers of health: Older Americans in the 1990s
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DOI：
10.1093/gerona/60.11.1409
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发表时间：
2005-11-01
影响因子：
5.1
通讯作者：
Seeman, T
中科院分区：
文献类型：
--
作者：
Crimmins, EM;Alley, D;Seeman, T
背景许多显示老年人健康状况改善的研究都依赖于主观健康指标。这篇文章评估了20世纪90年代美国老年人的生理状况的变化，使用高风险的发病率和死亡率的生物措施。在全国健康与营养调查（NHANES）111（1988-1994）和IV（1999-2000）中，对年龄65岁及以上的受访者中临床定义的10种生物标志物高风险患病率的变化进行了评估。生物标志物的高危值患病率的一些变化表明，20世纪90年代老年人的健康状况有所改善：高危总胆固醇患病率降低6%（p < .001），高危同型半胱氨酸患病率降低7%（p < .001）。其他变化表明健康状况恶化：高危收缩压患病率增加9%（p < .01），肥胖症患病率增加10%（p < .001），高危C反应蛋白患病率增加8%（p < .001）。这些变化在调整年龄，性别和教育后仍然显着。Logistic回归分析结果显示，用药频率、药物疗效、慢性病患病率和饮食的变化可以解释部分变化。1990年代生物标志物高风险值流行率的变化喜忧参半。降脂药物的更多使用和有效性有助于降低高风险血脂水平人群的百分比，叶酸补充剂降低了高风险同型半胱氨酸的百分比。然而，尽管抗高血压药物的使用增加，但高风险收缩压的百分比仍然增加，部分原因是抗高血压药物使血压低于高风险水平的能力有限。
Background. Many studies that show improved health in older adults have relied on subjective measures of health. This article assesses changes in the physiological status of older Americans during the 1990s using biological measures of high-risk for morbidity and mortality.Methods. Changes in the prevalence of clinically-defined, high risk for 10 biological markers were assessed in respondents age 65 years and older from National Health and Nutrition Examination Surveys (NHANES) 111 (1988-1994) and IV (1999-2000).Results. Some changes in prevalence of high-risk values of biological markers indicate improved health among older adults in the 1990s: a 6% reduction in the prevalence of high-risk total cholesterol (p < .001) and a 7% reduction in the prevalence of high-risk homocysteine (p < .001). Other changes indicate worsening health: a 9% increase in the prevalence of high-risk systolic blood pressure (p < .01), a 10% increase in obesity (p < .001), and an 8% increase in the prevalence of high-risk C-reactive protein (p < .001). These changes remained significant after adjusting for age, sex, and education. Results of logistic regressions indicate that changes in the frequency of medication usage, medication efficacy, prevalence of chronic disease, and diet explained some of these changes.Conclusions. Changes in the prevalence of high-risk values of biological markers in the 1990s are mixed. Greater use and effectiveness of lipid-lowering medication has contributed to the reduction in percentage of the population with high-risk lipid levels, and folate supplementation accounted for a decline in the percentage with high-risk homocysteine. However, increases in the percentage with high-risk systolic blood pressure occurred despite an increase in the use of antihypertensive medications, in part because of the limited ability of anti hypertensive medications to bring blood pressure below high-risk levels.