Food insecurity, comorbidity, and mobility limitations among older US adults: Findings from the Health and Retirement Study and Health Care and Nutrition Study
Food insecurity, comorbidity, and mobility limitations among older US adults: Findings from the Health and Retirement Study and Health Care and Nutrition Study
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DOI：
10.1016/j.ypmed.2018.07.001
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发表时间：
2018-09-01
影响因子：
5.1
通讯作者：
Wang, Kaipeng
中科院分区：
文献类型：
--
作者：
Bishop, Nicholas J.;Wang, Kaipeng
粮食不安全和并发症已被确定为老年人功能限制的前兆，但粮食不安全是否会改变从慢性疾病到残疾的进展尚未得到评估。我们调查了5986名年龄在50岁及以上的受访者，他们来自2012-2014年健康与退休研究（HRS）和2013年健康护理与营养研究（HCNS）。2014年报告的流动限制和2012年至2014年流动限制的变化，使用泊松回归对粮食不安全，慢性病数量及其相互作用项进行了回归。大约17.3%的样本被确定为粮食不安全。2012年，受访者平均报告1.9（SD = 1.5）例慢性病和2.4例行动受限（SD = 3.0）。2014年，个人平均报告2.5（SD = 3.1）次行动受限。在两年的观察期内，食物不安全与更多的活动受限相关（IRR = 1.20，95% CI：1.11-1.29，p <0.001），并且活动受限增加更快（IRR = 1.06，95% CI：1.00-1.11，p = 0.047）。粮食安全状况也修改了合并症和两个流动性限制的结果之间的关联，与粮食安全表现出更强的正相关慢性疾病和流动性限制比粮食不安全。在报告的慢性病很少的情况下，粮食无保障的人往往比粮食有保障的人有更多的流动性限制。我们的研究结果表明，粮食不安全与老年人中流动性限制的流行和变化有关。
Both food insecurity and comorbidity have been identified as precursors to functional limitation in older adults, yet whether food insecurity modifies the progression from chronic disease to disability has not been assessed. We examined 5986 respondents age 50 and older drawn from the 2012-2014 Health and Retirement Study (HRS) and 2013 Health Care and Nutrition Study (HCNS). Mobility limitations reported in 2014 and change in mobility limitations from 2012 to 2014 were regressed on measures of food insecurity, number of chronic conditions, and their interaction terms using Poisson regression. Around 17.3% of the sample was identified as food insecure. In 2012, respondents reported an average of 1.9 (SD = 1.5) chronic conditions and 2.4 mobility limitations (SD = 3.0). In 2014, individuals reported an average of 2.5 (SD = 3.1) mobility limitations. Food insecurity was associated with a greater number of mobility limitations (IRR = 1.20, 95% CI: 1.11-1.29, p < .001) and more rapid increase in mobility limitations over the two-year observational period (IRR = 1.06, 95% CI: 1.00-1.11, p = .047). Food security status also modified the association between comorbidity and both mobility limitation outcomes, with the food secure exhibiting a stronger positive association between chronic conditions and mobility limitations than the food insecure. The food insecure tended to have more mobility limitations than the food secure when few chronic conditions were reported. Our results suggest that food insecurity is associated with prevalence and change in mobility limitations among older adults.