Improved versus deteriorated physical functioning among long-term disabled elderly.
Improved versus deteriorated physical functioning among long-term disabled elderly.
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长期残疾老年人身体机能的改善与恶化。
DOI：
10.1097/00005650-199406000-00004
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发表时间：
1994
期刊：
影响因子：
3
通讯作者：
Boaz,RF
中科院分区：
文献类型：
--
作者：
Boaz,RF
对于长期残疾的老年人，通常的预后是他们不太可能改善或恢复独立功能。但计算的转移概率显示了显着的改善比例。根据1982年和1984年的全国长期护理调查，本研究确定了与这2年之间的功能状态变化相关的个人特征，并估计每个特征对这种变化的贡献。该研究区分了残疾老年人的四种相互排斥的状态：改善，保持不变，恶化活着，恶化死亡。它表明，1982年报告的认知障碍，1982年访谈前一年发生的高风险医疗事件，以及1982年至1984年期间的住院治疗，预测到1984年恶化的风险增加。然而，类似的估计并不能预测改善。然而，与报告的改善相一致的数据表明，急性医学问题可能导致功能状态暂时恶化。如果从这一状态恢复需要3个月以上的时间，随后发生的变化可能在初次调查中被记录为长期残疾，并随着时间的推移被记录为改善。然而，长期残疾的老年人很少改善到他们在身体功能上完全恢复独立的程度。在这项研究中，大多数改善的老年人最终的功能状态与ADL残疾的人随着时间的推移保持不变。
The usual prognosis for long-term disabled elderly is that they are not likely to improve or regain independent functioning. But computed transition probabilities reveal a significant proportion of improvement. Based on the National Long-Term Care Surveys of 1982 and 1984, this study identifies the personal characteristics that are associated with changed functional status between these 2 years and estimates how much each characteristic contributes to this change. The study distinguishes four mutually exclusive statuses of disabled older persons: improved, remaining unchanged, deteriorated-alive, and deteriorateddead. It shows that cognitive impairment reported in 1982, high-risk medical events that occurred during the year before the 1982 interview, and hospitalization between 1982 and 1984 predict an increased risk of deterioration by 1984. However, similar estimates do not predict improvement. Yet, data compatible with reported improvement suggest that acute medical problems might have caused a temporary worsening of functional status. When the recovery from this status takes more than 3 months, the ensuing change may be recorded as a long-term disability in the initial survey and as an improvement over time. However, long-term disabled elderly seldom improve to such an extent that they regain complete independence in physical functioning. In this study, most of the elderly who improved ended with a functional status similar to that of persons whose ADL disabilities remained unchanged over time.