Risk factors for disability in older persons over 3-year follow-up
Risk factors for disability in older persons over 3-year follow-up
复制标题
DOI：
10.1093/ageing/afp209
复制
发表时间：
2010-01-01
期刊：
影响因子：
6.7
通讯作者：
Guralnik, Jack M.
中科院分区：
文献类型：
--
作者：
Balzi, Daniela;Lauretani, Fulvio;Guralnik, Jack M.
目的：确定残疾和危险因素的发展活动的日常生活（ADL）和工具性ADL（IADL）残疾的社区居住的老年adules.Methods：研究人群包括897名受试者，年龄65-102岁，从InCHIANTI研究，一个人口为基础的队列在托斯卡纳（意大利）。结果：897例患者中，ADL和IADL的基线患病率分别为5.5%（49/897）和22.2%（199/897）。在基线时无ADL残疾的848名参与者中，72名发展为ADL残疾，49名已经残疾的参与者中有25名在3年的随访中ADL残疾恶化。在基线时没有IADL残疾的698名参与者中，100名发展为IADL残疾，199名已经有IADL残疾的参与者中有104名在3年内IADL残疾恶化。在完全校正的模型中，与久坐状态相比，高水平的体力活动与3年随访访视时ADL和IADL残疾的发生率较低显著相关（ADL残疾的比值比（OR）：0.30; 95%置信区间（CI）0.12-0.76，IADL残疾的OR：0.18; 95% CI 0.09-0.36）。在调整多个混杂因素后，较高的能量摄入（100 kcal/天差异的OR：1.09; 95% CI 1.02-1.15）和高血压（OR：1.91; 95%CI 1.06-3.43）是ADL残疾发生或恶化的显著危险因素。较高的体力活动水平和较低的能量摄入可能对老年人ADL和IADL残疾的发展具有保护作用。
Purpose: to identify cross-sectional correlates of disability and risk factors for the development activities of daily living (ADL) and instrumental ADL (IADL) disability in community-dwelling older adults.Methods: the study population consisted of 897 subjects aged 65-102 years from the InCHIANTI study, a population-based cohort in Tuscany (Italy). Factors potentially associated with high risk of disability were measured at baseline (1998-2000), and disability in ADLs and IADLs were assessed both at baseline and at the 3-year follow-up (2001-03).Results: the baseline prevalence of ADL disability and IADL disability were, respectively, 5.5% (49/897) and 22.2% (199/897). Of 848 participants free of ADL disability at baseline, 72 developed ADL disability and 25 of the 49 who were already disabled had a worsening in ADL disability over a 3-year follow-up. Of 698 participants without IADL disability at baseline, 100 developed IADL disability and 104 of the 199 who already had IADL disability had a worsening disability in IADL over 3 years. In a fully adjusted model, high level of physical activity compared to sedentary state was significantly associated with lower incidence rates of both ADL and IADL disability at the 3-year follow-up visit (odds ratio (OR): 0.30; 95% confidence intervals (CI) 0.12-0.76 for ADL disability and OR: 0.18; 95% CI 0.09-0.36 for IADL disability). After adjusting for multiple confounders, higher energy intake (OR for difference in 100 kcal/day: 1.09; 95% CI 1.02-1.15) and hypertension (OR: 1.91; 95% CI 1.06-3.43) were significant risk factors for incident or worsening ADL disability.Conclusions: higher level of physical activity and lower energy intake may be protective against the development in ADL and IADL disability in older persons.