Gender Differences in Trajectories of Lower Extremity Function in Older Adults: Findings From the International Mobility in Aging Study
Gender Differences in Trajectories of Lower Extremity Function in Older Adults: Findings From the International Mobility in Aging Study
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DOI：
10.1016/j.jamda.2019.04.014
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发表时间：
2019-10-01
影响因子：
7.6
通讯作者：
Auais, Mohammad
中科院分区：
文献类型：
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作者：
Ahmed, Tamer;French, Simon D.;Auais, Mohammad
目标：我们检查了 4 岁以上老年男性和女性的下肢功能轨迹以及这些轨迹的基线预测因素。设计：国际队列研究的纵向分析。背景和参与者：国际老龄化流动性研究 (IMIAS) 中基线年龄在 65 至 74 岁之间的老年人。测量：2012 年测量下肢的身体机能，并于 2012 年进行随访。 2014 年和 2016 年，使用短期物理性能电池 (SPPB)。对按性别划分的身体表现进行了基于群体的轨迹分析。使用多项逻辑回归分别推导出男性和女性身体表现轨迹与潜在基线预测因子之间的相对风险比（置信区间为 95%）。 结果：在男性和女性中确定了三种身体表现轨迹：高度稳定（30.0% vs 35.5%）、逐渐功能衰退（63.1% vs 54.3%）和快速功能衰退（6.9% vs 10.2%）。与男性和女性逐渐功能衰退和快速功能衰退轨迹组的成员相关的共同基线特征是年龄、单一婚姻状况和多种慢性病（>3）。在男性中，抑郁症是功能快速衰退轨迹组成员的有力预测因素。功能快速衰退轨迹组中的女性更容易肥胖，具有女性化和未分化的性别角色，并且基线自评健康状况较差。结论/启示：老年人的身体表现轨迹和相关因素存在性别差异。旨在预防或减缓老年功能衰退的计划应对性别敏感。 (C) 2019 AMDA - 急性后和长期护理医学协会。
Objectives: We examined the lower extremity function trajectories of older men and women over 4 years and baseline predictors of these trajectories.Design: Longitudinal analysis of an international cohort study.Settings and participants: Older adults from the International Mobility in Aging Study (IMIAS) aged between 65 and 74 years at baseline.Measures: Physical performance of the lower extremities was measured in 2012, with follow-ups in 2014 and in 2016, using the Short Physical Performance Battery (SPPB). Group-based trajectory analysis of physical performance by gender was performed. Multinomial logistic regression was used to derive relative risk ratios with 95% confidence intervals between the physical performance trajectories and the potential baseline predictors in men and women separately.Results: Three physical performance trajectories were identified in men and women: high-stable (30.0% vs 35.5%), gradual functional decline (63.1% vs 54.3%), and rapid functional decline (6.9% vs 10.2%). Common baseline characteristics associated with memberships in the gradual functional decline and rapid functional decline trajectory groups in men and women were age, single marital status, and multiple chronic conditions (>3). Among men, depression was a strong predictor of the membership in the rapid functional decline trajectory group. Women in the rapid functional decline trajectory group were more likely to be obese, with feminine and undifferentiated gender roles, and have poor self-rated health at baseline.Conclusions/Implications: There are gender differences in the physical performance trajectories and related factors among older adults. Programs aiming at preventing or slowing functional decline in old age should be sensitive to gender. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.