Psycho-social activity factors associated with self-rated health among community-dwelling elderly people A five-year longitudinal study
Psycho-social activity factors associated with self-rated health among community-dwelling elderly people A five-year longitudinal study
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社区老年人健康自评相关心理社会活动因素 五年纵向研究
DOI：
10.11236/jph.62.9_537
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
山内加奈子，斉藤功，加藤匡宏，谷川武，小林敏生
中科院分区：
文献类型：
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作者：
Yamauchi Kanako;Saito Isao;Kato Tadahiro;山内加奈子，斉藤功，加藤匡宏，谷川武，小林敏生
目的研究社区老年人自评健康不良的心理和社会活动相关因素。方法对日本爱贤县桐城7,413名65岁及以上老年人的一般健康状况进行调查。我们在五年的时间里跟踪了4372名参与者，排除了那些85岁及以上、残疾、搬走或死亡的人。对3358名受访者(回复率：76.8%)的数据进行了分析。我们根据患者的SRH反应将患者分为两组：健康组，包括回答“优秀”或“良好”的人；不健康组，包括回答“不好”或“差”的人。我们检查了两组在第一次调查和五年后进行的调查之间SRH的变化。在第一次调查的健康受试者中，我们用Logistic回归分析了五年后SRH与心理社会活动因素的关系。这些因素包括身体和社交能力、生活满意度以及痴呆症和/或抑郁的倾向。在5年的随访期后，65-74岁的男性和女性保持SRH为健康的比例约为60%，而75-84岁的男性和女性的比例约为40%。在65-74岁的人群中，与生活满意度指数K(LSI-K)得分(第一次调查)相关的不健康SRH的优势比(OR)男性显著低于女性，分别为0.85(95%可信区间：0.77-0.93)和0.79(95%可信区间：0.72-0.87)。仅在女性中，抑郁倾向的OR显著高于女性，为1.68(95%CI：1.11-2.56)。在75-84岁的人中，与LSI-K评分(第一次调查)相关的不健康SRH(5年后)的OR显著低于女性，男性为0.87(95%CI：0.77-1.00)，女性为0.89(95%CI：0.80-0.99)。东京都老年研究所得分较高的男性和女性的OR值分别为0.80(95%CI：0.70~0.91)和0.88(95%CI：0.80~0.97)，差异有统计学意义。研究还表明，在75岁以下的老年女性中预防抑郁症，并在75-84岁的老年男性和女性中保持身体和社会能力，对于维持SRH地位是重要的。
ObjectivesThis longitudinal study examined psychological and social activity factors related to poor self-rated health (SRH) in community-dwelling elderly people.MethodsThe general health of 7,413 elderly individuals aged 65 years and over in Toon City, Ehime Prefecture, Japan was surveyed. We followed 4,372 participants, over a five-year period, after excluding those who were aged 85 years and over, had a disability, had moved away, or had died. The data from 3,358 respondents (response rate: 76.8%) were analyzed. We divided the patients into two groups based on their SRH responses: healthy, including those who answered" excellent" or" good," and unhealthy, including those who answered" not good" or" poor." We examined changes in SRH for both groups between the first survey and the survey conducted after five years. Among the healthy subjects at the first survey, we analyzed the relationship between SRH, after five years, and psycho-social activity factors using a logistic regression analysis. These factors included physical and social competence, life satisfaction, and tendency towards dementia and/or depression.ResultsSRH of both men and women significantly declined over five years. The percentage of men and women, who maintained SRH as healthy, after the 5-year follow-up period, was approximately 60% in those aged 65-74 years and 40% in those aged 75-84 years. In those aged 65-74 years, the odds ratio (OR) for a SRH of unhealthy (after five years), associated with Life Satisfaction Index-K (LSI-K) scores (at the first survey), was significantly lower at 0.85 (95% confidence interval [CI]: 0.77-0.93) for men and 0.79 (95% CI: 0.72-0.87) for women. The OR of tendency toward depression was significantly higher at 1.68 (95% CI: 1.11-2.56) for women only. In those aged 75-84 years, the OR for a SRH of unhealthy (after five years), associated with LSI-K scores (at the first survey), was significantly lower at 0.87 (95% CI: 0.77-1.00) for men and 0.89 (95% CI: 0.80-0.99) for women. The OR for higher Tokyo Metropolitan Institute of Gerontology scores was significantly lower at 0.80 (95% CI: 0.70-0.91) for men and 0.88 (95% CI: 0.80-0.97) for women.ConclusionThis study shows that it is necessary to increase life satisfaction for preventing a decline in SRH in community-dwelling elderly. It also shows that preventing depression in elderly women under the age of 75 years and maintaining physical and social competence in both elderly men and women aged 75-84 years are important for maintaining the SRH status.