Development of and Recovery From Difficulty With Activities of Daily Living: An Analysis of National Data
Development of and Recovery From Difficulty With Activities of Daily Living: An Analysis of National Data
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DOI：
10.1177/0898264310375986
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发表时间：
2010-12-01
影响因子：
2.8
通讯作者：
Siu, Albert L.
中科院分区：
文献类型：
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作者：
Federman, Alex D.;Penrod, Joan D.;Siu, Albert L.
背景：需要有关老年人轻度身体损伤预测因素的国家级数据，以帮助决策者进行资源分配。方法：我们分析了来自医疗保险现行受益人调查（MCBS）的64岁以上无日常生活活动（ADL）困难的成年人（n = 14,226）的基线数据。每年测量5次ADL，恢复定义为在随访中恢复完全ADL功能。结果：与ADL困难最相关的是抗精神病药物的使用（调整优势比[AOR] = 1.93, 95%可信区间[CI] = 1.44至2.58）、辅助ADL困难（AOR = 1.90, 95% CI = 1.74至2.07）和一般健康状况（AOR = 1.59, 95% CI = 1.42至1.78）。只有ADL困难事件的数量与恢复相关（AOR = 0.02, 95% CI = 0.01 ~ 0.02）。结论：确定与轻度肢体损伤发展相关的因素有助于指导患者进行预防性保健计划，以预防身体功能的下降。
Background: National-level data are needed on predictors of mild physical impairment among older adults to assist policy makers with resource allocation. Method: We analyzed data on adults above age 64 from the Medicare Current Beneficiary Survey (MCBS) with no activity of daily living (ADL) difficulties at baseline (n = 14,226). Five ADLs were measured annually and recovery was defined as regaining complete ADL function at follow-up. Results: The strongest correlates of ADL difficulty were use of antipsychotic medications (adjusted odds ratio [AOR] = 1.93, 95% confidence interval [CI] = 1.44 to 2.58), instrumental ADL difficulty (AOR = 1.90, 95% CI = 1.74 to 2.07), and fair-poor general health (AOR = 1.59, 95% CI = 1.42 to 1.78). Only the number of incident ADL difficulties was associated with recovery (AOR = 0.02, 95% CI = 0.01 to 0.02). Conclusion: Identifying factors associated with development of mild physical impairment could help direct patients toward preventive care programs to preempt decline in physical function.