Healthy ageing for all? Comparisons of socioeconomic inequalities in health expectancies over two decades in the Cognitive Function and Ageing Studies I and II.
Healthy ageing for all? Comparisons of socioeconomic inequalities in health expectancies over two decades in the Cognitive Function and Ageing Studies I and II.
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DOI：
10.1093/ije/dyaa271
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发表时间：
2021-07-09
影响因子：
7.7
通讯作者：
Jagger C
中科院分区：
文献类型：
--
作者：
Bennett HQ;Kingston A;Spiers G;Robinson L;Corner L;Bambra C;Brayne C;Matthews FE;Jagger C
尽管预期寿命不断增加，但横截面数据显示，许多国家按社会经济地位划分的无残疾预期寿命不平等现象不断扩大。我们使用纵向数据来更好地了解SES的DFLE和独立年份（IndLE）的趋势，以及潜在的转变如何做出贡献。认知功能和衰老研究（CFAS I和II）是在三个英国中心（纽卡斯尔、诺丁汉和剑桥郡）对年龄≥65岁的患者进行的大型基于人群的研究，基线约为1991年（CFAS I，n = 7635）和2011年（CFAS II，n = 7762），随访时间为2年。我们将残疾定义为日常生活活动（ADL）困难，将ADL和反映所需护理的认知相结合的依赖性，以及区域水平剥夺的SES。残疾或依赖状态和死亡之间的过渡估计从多状态模型。在1991年至2011年期间，大多数男性和女性在65岁时的DFLE增益最大[男性：4.7年，95%置信区间（95% CI）3.3-6.2;女性：2.8年，95% CI 1.3-4.3]。收益是由于大多数女性的事件残疾风险降低[相对风险比（RRR）：0.7，95% CI 0.5-0.8]，而大多数男性的康复可能性更大（RRR：1.8，95% CI 1.0-3.2），无残疾死亡风险降低（RRR：0.4，95% CI 0.3-0.6）。最低死亡率男性的残疾死亡风险降低（RRR：0.7，95% CI 0.6-0.9）;最低死亡率女性在过渡期几乎没有改善。不同时间的IndLE模式相似。预防应针对最弱势地区，以缩小不平等，并让最弱势地区明确表明减少贫困过渡是可以实现的。
Despite increasing life expectancy (LE), cross-sectional data show widening inequalities in disability-free LE (DFLE) by socioeconomic status (SES) in many countries. We use longitudinal data to better understand trends in DFLE and years independent (IndLE) by SES, and how underlying transitions contribute. The Cognitive Function and Ageing Studies (CFAS I and II) are large population-based studies of those aged ≥65 years in three English centres (Newcastle, Nottingham, Cambridgeshire), with baseline around 1991 (CFAS I, n = 7635) and 2011 (CFAS II, n = 7762) and 2-year follow-up. We defined disability as difficulty in activities of daily living (ADL), dependency by combining ADLs and cognition reflecting care required, and SES by area-level deprivation. Transitions between disability or dependency states and death were estimated from multistate models. Between 1991 and 2011, gains in DFLE at age 65 were greatest for the most advantaged men and women [men: 4.7 years, 95% confidence interval (95% CI) 3.3–6.2; women: 2.8 years, 95% CI 1.3–4.3]. Gains were due to the most advantaged women having a reduced risk of incident disability [relative risk ratio (RRR):0.7, 95% CI 0.5–0.8], whereas the most advantaged men had a greater likelihood of recovery (RRR: 1.8, 95% CI 1.0–3.2) and reduced disability-free mortality risk (RRR: 0.4, 95% CI 0.3–0.6]. Risk of death from disability decreased for least advantaged men (RRR: 0.7, 95% CI 0.6–0.9); least advantaged women showed little improvement in transitions. IndLE patterns across time were similar. Prevention should target the most disadvantaged areas, to narrow inequalities, with clear indication from the most advantaged that reduction in poor transitions is achievable.
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影响因子：
168.9
作者：
Matthews, Fiona E.;Arthur, Antony;Barnes, Linda E.;Bond, John;Jagger, Carol;Robinson, Louise;Brayne, Carol
通讯作者：
Brayne, Carol
影响因子：
7.7
作者：
Jagger, Carol;Matthews, Ruth;Brayne, Carol
通讯作者：
Brayne, Carol
影响因子：
3.4
作者：
Bronnum-Hansen, Henrik;Eriksen, Mette Lindholm;Jeune, Bernard
通讯作者：
Jeune, Bernard
影响因子：
3.7
作者：
Matthews, Fiona E.;Bennett, Holly;Brayne, Carol
通讯作者：
Brayne, Carol
影响因子：
3.7
作者：
Adams J;Stamp E;Nettle D;Milne EM;Jagger C
通讯作者：
Jagger C