Long-term function in an older cohort--the cardiovascular health study all stars study.
Long-term function in an older cohort--the cardiovascular health study all stars study.
复制标题
DOI：
10.1111/j.1532-5415.2008.02152.x
复制
发表时间：
2009-03
影响因子：
6.3
通讯作者：
Robbins J
中科院分区：
文献类型：
--
作者：
Newman AB;Arnold AM;Sachs MC;Ives DG;Cushman M;Strotmeyer ES;Ding J;Kritchevsky SB;Chaves PH;Fried LP;Robbins J
评估维持身体和认知功能到第9个十年及以后的共同和独特的风险因素。纵向队列研究。四个美国社区。心血管健康研究全明星研究的1677名参与者，在2005/06年进行评估。中位年龄：85岁（范围77-102岁），66.5%为女性，16.6%为黑人。完整的功能定义为没有任何日常生活活动的困难，并在改良的简易精神检查评分≥ 80。基线特征评估在1992/93年包括人口统计学，行为健康因素，慢性疾病史，亚临床疾病标志物，心血管危险因素和炎症标志物。采用多项逻辑回归分析比较肢体残疾、认知功能障碍、合并功能障碍与无功能障碍的风险。在这两个领域评估的1677名参与者中，891名（53%）功能完整。包括数字符号替代测试和步态速度在内的连续功能测量显示，所有组，包括功能最强的组，都随着时间的推移而下降。功能组下降较少，但也倾向于具有较高的起始值。与身体或认知障碍或两者兼而有之的人相比，功能性个体的基线健康状况非常高。女性和体重较高的个体有较高的身体损伤率，但没有认知障碍。这两种类型的损害的共同危险因素包括心血管疾病和高血压。在这些老年人中，只有大约一半的人在第9个十年及以后发现了完整的功能。高基线功能和低血管疾病风险是功能性衰老的特征。
To evaluate both shared and unique risk factors for maintaining physical and cognitive function into the 9th decade and beyond. Longitudinal cohort study. Four US communities. 1677 participants in the Cardiovascular Health Study All Stars Study, assessed in 2005/06. Median age: 85 (range 77-102), 66.5% women, 16.6% black. Intact function was defined as no difficulty with any activities of daily living and a score >=80 on the Modified Mini-Mental Exam. Baseline characteristics assessed in 1992/93 included demographics, behavioral health factors, chronic disease history, subclinical disease markers, cardiovascular risk factors and inflammatory markers. Multinomial logistic regression was used to compare risk for physical disability, cognitive impairment, combined impairments vs. no functional impairment. Of the 1677 participants evaluated in both domains, 891 (53%) were functionally intact. Continuous measures of function, including the Digit Symbol Substitution Test and gait speed showed that all groups, including the most functional, had declined over time. The functional group had less decline, but also tended to have higher starting values. Functional individuals had a very high baseline health profile compared to those with either physical or cognitive impairment or both impairments combined. Women and individuals with higher weight had higher rates of physical impairment but not cognitive impairment. Risk factors common to both types of impairment included cardiovascular disease and hypertension. Intact function was found in only about half of these older adults in the 9th decade and beyond. High baseline function and low vascular disease risk characterized functional aging.