Can a Healthy Lifestyle Compress the Disabled Period in Older Adults?
Can a Healthy Lifestyle Compress the Disabled Period in Older Adults?
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DOI：
10.1111/jgs.14314
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发表时间：
2016-10
影响因子：
6.3
通讯作者：
Newman AB
中科院分区：
文献类型：
--
作者：
Jacob ME;Yee LM;Diehr PH;Arnold AM;Thielke SM;Chaves PH;Gobbo LD;Hirsch C;Siscovick D;Newman AB
确定在生命晚期测量的生活方式因素是否会将残疾期压缩到生命的尽头。基于社区的老年人队列研究从1989年到2015年。四个美国社区。年龄≥ 65岁的男性和女性（N= 5248，平均年龄72.7 ± 5.5岁，57%为女性，15.2%为少数民族），居住在社区，不依赖轮椅，能够在基线时提供知情同意。在基线时测量多种生活方式因素，包括吸烟、饮酒、体力活动、饮食、体重指数（BMI）、社交网络和社会支持。在基线和整个随访期间评估日常生活活动（ADL）。寿命年数（约尔）定义为直至死亡的年数。生活能力年数（YAL）定义为没有任何ADL困难的年数。YAL/约尔%，即能够生活的生命比例，用于表示残疾期的相对压缩/扩展。女性的平均残疾持续时间为4.5年（平均约尔数为15.4），男性为2.9年（平均约尔数为12.4）。在多变量模型中，肥胖（与正常BMI相比）与7.3%（95%CI，5.4-9.2）的YAL/约尔%降低相关。在替代健康饮食指数的最低五分位中的得分（与最高得分相比）与YAL/约尔%降低3.7%（95%CI，1.6-5.9）相关。一周内每走25个街区与YAL/约尔%高0.5%（95%CI，0.3-0.8）相关。健康的生活方式因素对未来无残疾生活的比例的影响表明，如果这些因素正确结合，残疾期可以缩短。
To determine whether lifestyle factors measured late in life could compress the disabled period towards the end of life. Community-based cohort study of older adults followed from 1989 to 2015. Four US communities. Men and women ages 65 and older (N= 5248, mean age 72.7 ± 5.5 years, 57% women, 15.2% minority) who were living in the community, not wheel-chair dependent and able to give informed consent at baseline. Multiple lifestyle factors including smoking, alcohol consumption, physical activity, diet, body mass index (BMI), social networks and social support were measured at baseline. Activities of Daily Living (ADL) were assessed at baseline and throughout follow-up. Years of Life (YoL) was defined as years until death. Years of Able Life (YAL) was defined as years without any ADL difficulty. YAL/YoL%, the proportion of life lived able, was used to indicate the relative compression/expansion of the disabled period. The average duration of disabled years was 4.5 (out of 15.4 mean YoL) for women and 2.9 (out of 12.4 mean YoL) for men. In a multivariable model, obesity (compared to normal BMI) was associated with 7.3% (95% CI, 5.4–9.2) lower YAL/YoL%. Scores in the lowest quintile of the Alternate Healthy Eating Index (compared to highest) were associated with a 3.7% (95% CI, 1.6–5.9) lower YAL/YoL%. Every 25 blocks walked in a week was associated with 0.5% (95% CI, 0.3–0.8) higher YAL/YoL%. The effects of healthy lifestyle factors on the proportion of future life lived free of disability indicate that the disabled period can be compressed, given the right combination of these factors.