A life-course approach to healthy ageing: maintaining physical capability
A life-course approach to healthy ageing: maintaining physical capability
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DOI：
10.1017/s0029665113003923
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发表时间：
2014-05-01
影响因子：
7
通讯作者：
Cooper, Rachel
中科院分区：
文献类型：
--
作者：
Kuh, Diana;Karunananthan, Sathya;Cooper, Rachel
关于健康老龄化的研究缺乏一致同意的概念框架，也没有充分考虑到越来越多的证据表明，从生命早期开始的社会和生物因素会影响以后的健康。我们在生命历程框架内概念化健康老龄化，将健康的生物老龄化（在最佳身体和认知功能、延缓慢性疾病的发作以及尽可能延长寿命方面）与心理和社会福祉的变化分开。我们总结了健康老龄化指标审查的结果，重点关注身体能力的客观测量，例如握力、步行速度、椅子上升和站立平衡测试，旨在捕捉个人层面的身体功能，评估承担日常生活体力任务的能力。有强有力的证据表明，这些指标的得分越高，死亡率越低，而有关发病风险较低以及与年龄相关的变化模式的证据则更为有限。根据英国队列研究的合作研究，我们总结了关于终生社会经济地位、体型和生活方式以及基础生理学和遗传学方面对身体能力的影响的已知信息；迄今为止的证据支持已确定为慢性病危险因素的一系列广泛因素。我们认为需要进行更大规模的纵向研究，以调查这些客观指标中与年龄相关的变化和种族多样性、它们之间的动态关系，以及它们与健康老龄化的其他组成指标的关系。队列研究中强有力的证据，在明确的概念框架内使用标准化措施，将有利于促进健康老龄化的政策和实践。
Research on healthy ageing lacks an agreed conceptual framework and has not adequately taken into account the growing evidence that social and biological factors from early life onwards affect later health. We conceptualise healthy ageing within a life-course framework, separating healthy biological ageing (in terms of optimal physical and cognitive functioning, delaying the onset of chronic diseases, and extending length of life for as long as possible) from changes in psychological and social wellbeing. We summarise the findings of a review of healthy ageing indicators, focusing on objective measures of physical capability, such as tests of grip strength, walking speed, chair rises and standing balance, which aim to capture physical functioning at the individual level, assessing the capacity to undertake the physical tasks of daily living. There is robust evidence that higher scores on these measures are associated with lower rates of mortality, and more limited evidence of lower risk of morbidity, and of age-related patterns of change. Drawing on a research collaboration of UK cohort studies, we summarise what is known about the influences on physical capability in terms of lifetime socioeconomic position, body size and lifestyle, and underlying physiology and genetics; the evidence to date supports a broad set of factors already identified as risk factors for chronic diseases. We identify a need for larger longitudinal studies to investigate age-related change and ethnic diversity in these objective measures, the dynamic relationships between them, and how they relate to other component measures of healthy ageing. Robust evidence across cohort studies, using standardised measures within a clear conceptual framework, will benefit policy and practice to promote healthy ageing.