Risk Factor for Incident Functional Disability and the Effect of a Preventive Exercise Program: A 4-Year Prospective Cohort Study of Older Survivors from the Great East Japan Earthquake and Nuclear Disaster.
Risk Factor for Incident Functional Disability and the Effect of a Preventive Exercise Program: A 4-Year Prospective Cohort Study of Older Survivors from the Great East Japan Earthquake and Nuclear Disaster.
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DOI：
10.3390/ijerph15071430
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发表时间：
2018-07-06
影响因子：
--
通讯作者：
Yasumura S
中科院分区：
文献类型：
--
作者：
Kuroda Y;Iwasa H;Orui M;Moriyama N;Suemoto CK;Yashiro C;Matsuda K;Yasumura S
目的：研究日本东部大地震和核灾难(Geje)后Iitate村长期疏散人员事件功能残疾的危险因素。我们还调查了在这种情况下，锻炼课作为一种干预措施的有效性。方法：1159例受试者，年龄(75.2±5.8)岁，女性占57.5%，均为基线，随访4年。采用COX比例风险回归分析方法，根据本市自评基本量表(BCL)评价危险因素的存在情况，估计发生功能性残疾的危险比(HR)。使用倾向性分数对参加训练班的饭馆疏散人员和没有参加锻炼课程的疏散人员进行匹配，然后用这些得分来获得事件功能残疾的HR。结果：280例(24.2%)患者在随访过程中出现新的功能障碍。BCL中身体功能领域得分为负分的参与者发生功能性残疾的比率为2.04(95%CI：1.54-2.69)，而该领域得分为正的参与者发生功能障碍的比率为2.04(95%CI：1.54-2.69)。同样，“认知功能”的HR为1.37(CI：1.06-1.77)，“抑郁”的HR为1.60(CI：1.24-2.08)。经Cox比例风险回归模型分析，低参与锻炼组和高参与锻炼组的功能障碍发生率均显著低于完全不参加锻炼组(HR=0.27，CI：0.16~0.46；HR=0.30，CI：0.12~0.74)。结论：灾前bcl域有助于识别重大社会技术灾难后有功能性残疾风险的个体。因此，这一工具可以用来识别高危老年人，他们将受益于早期运动计划，以防止意外发生的功能性残疾。
Objective: The aim of this study is to assess the risk factors for incident functional disability among long-term evacuees of Iitate village after Great East Japan Earthquake and nuclear disaster (GEJE). We also investigated the effectiveness of exercise classes as an intervention measure in this situation. Methods: 1159 subjects (75.2 ± 5.8 years, 57.5% female) were included at baseline, and followed-up for four years. Cox proportional hazard regression analysis was used to estimate the hazard ratio (HR) of incident functional disability according to the presence of risk factors evaluated by the municipality’s self-assessment Basic Checklist (BCL). Evacuees from Iitate who participated in the exercise classes and those who did not were matched using the propensity scores, which were then used to obtain the HR of incident functional disability. Results: New functional disability occurred in 280 (24.2%) participants during the follow-up. Participants who scored negative for the “Physical function” domain in the BCL had a HR of 2.04 (95% CI: 1.54–2.69) for incident functional disability when compared to those who scored positive for this domain. Similarly, the HR for “Cognitive function” was 1.37 (CI: 1.06–1.77), and 1.60 (CI: 1.24–2.08) for “Depression”. Using a Cox proportional hazard regression model, both the group with low-participation in the exercise program and the group with high-participation in the exercise program had a significantly lower rate of incident functional disability compared to those who did not participate at all (HR = 0.27, CI: 0.16–0.46; HR = 0.30, CI: 0.12–0.74, respectively). Conclusions: Pre-disaster BCL domains were useful to identify individuals at risk of functional disability after a major socio-technical disaster. Therefore, this instrument can be used to identify at-risk older adults who would benefit from early exercise programs to prevent incident functional disability.
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影响因子：
4.3
作者：
Satoh H;Ohira T;Hosoya M;Sakai A;Watanabe T;Ohtsuru A;Kawasaki Y;Suzuki H;Takahashi A;Kobashi G;Ozasa K;Yasumura S;Yamashita S;Kamiya K;Abe M
通讯作者：
Abe M
影响因子：
4
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Ueki, Shouzoh
影响因子：
11.1
作者：
Suzuki, Yuriko;Yabe, Hirooki;Abe, Masafumi
通讯作者：
Abe, Masafumi
影响因子：
4.1
作者：
Dunn, AL;Trivedi, MH;O'Neal, HA
通讯作者：
O'Neal, HA
影响因子：
5.4
作者：
Tomata, Yasutake;Suzuki, Yoshinori;Tsuji, Ichiro
通讯作者：
Tsuji, Ichiro