Visual trajectories and risk of physical and cognitive impairment among older Chinese adults
Visual trajectories and risk of physical and cognitive impairment among older Chinese adults
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DOI：
10.1111/jgs.17311
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发表时间：
2021-06-10
影响因子：
6.3
通讯作者：
Xu, Beibei
中科院分区：
文献类型：
--
作者：
Cao, Guiying;Wang, Kaipeng;Xu, Beibei
背景/目的识别中国老年人的视觉轨迹并研究其与身体和认知功能的关系。设计基于人群的纵向研究。设置中国健康长寿纵向调查。参与者共16，151名年龄≥ 65岁的参与者。测量视觉、身体和认知功能。在基线和随后每3年评估一次日常生活活动能力[ADL]和工具性ADL [IADL]和认知功能。ADI残疾和IADL残疾分别定义为在Katz量表和改良Lawton量表的任何项目中需要任何帮助。认知障碍定义为中文版简易精神状态检查量表评分低于24分。一个基于组的轨迹模型被用来确定调整年龄，性别和教育的视觉轨迹。协会的视觉轨迹与ADL残疾，IADL残疾，认知功能障碍进行了评估，使用广义估计方程模型调整潜在confers.Results本研究确定了三个不同的视觉轨迹，包括没有下降（32.4%），中度下降（48.3%），进行性下降（19.3%）在随访期间。与没有下降的轨迹相比，（ADL功能障碍：OR = 2.75，95%CI：2.30 - 3.28; IADL功能障碍：OR = 3.01，95%CI：2.74 - 3.31;认知功能障碍：OR = 3.37，95%CI：3.02 - 3.76）（ADL残疾：OR = 8.50，95% CI：6.55 - 11.02; IADL残疾：OR = 12.96，95% CI：9.95 - 16.87;认知障碍：OR = 10.84，95% CI：8.89 - 13.23）轨迹与功能障碍风险增加显著相关。与中度下降轨迹相比，进行性下降轨迹与ADL残疾风险增加显著相关（OR = 3.09，95%CI：2.46 - 3.89），IADL残疾（OR = 4.30，95%CI：3.29-5.61），认知功能损害结论中国老年人存在3种不同的视觉轨迹，视力下降者发生功能损害的危险性高于视力未下降者。
Background/Objectives To identify visual trajectories and examine their relationships with physical and cognitive function in older Chinese adults.Design Population-based longitudinal study.Setting The Chinese Longitudinal Healthy Longevity Survey.Participants A total of 16,151 participants aged >= 65 years.Measurements Visual, physical (including activities of daily living [ADL] and instrumental ADL [IADL]), and cognitive function were assessed at baseline and subsequently every 3 years. ADI disability and IADL disability were defined as needing any help in any item of the Katz scale and a modified Lawton's scale, respectively. Cognitive impairment was defined as a Chinese version of the Mini-Mental State Examination score below 24. A group-based trajectory model was used to determine visual trajectories adjusted for age, sex, and education. Associations of visual trajectories with ADL disability, IADL disability, and cognitive impairment were evaluated using generalized estimating equation models adjusted for potential confounders.Results This study identified three distinct visual trajectories, including no decline (32.4%), moderate decline (48.3%), and progressive decline (19.3%) during the follow-up period. Compared with the no decline trajectory, both the moderate decline (ADL disability: OR = 2.75, 95% CI: 2.30-3.28; IADL disability: OR = 3.01, 95% CI: 2.74-3.31; cognitive impairment: OR = 3.37, 95% CI: 3.02-3.76) and the progressive decline (ADL disability: OR = 8.50, 95% CI: 6.55-11.02; IADL disability: OR = 12.96, 95% CI: 9.95-16.87; cognitive impairment: OR = 10.84, 95% CI: 8.89-13.23) trajectories were significantly associated with an increased risk of functional impairment. Compared with the moderate decline trajectory, the progressive decline trajectory was significantly associated with an increased risk of ADL disability (OR = 3.09, 95% CI: 2.46-3.89), IADL disability (OR = 4.30, 95% CI: 3.29-5.61), and cognitive impairment (OR = 3.22, 95% CI:2.63-3.93).Conclusion Older Chinese adults exhibit three distinct visual trajectories and those with decline trajectories in vision have an increased risk of functional impairment than those with a trajectory of no decline in vision.