Physical function and self-rated health status as predictors of mortality: results from longitudinal analysis in the ilSIRENTE study.
Physical function and self-rated health status as predictors of mortality: results from longitudinal analysis in the ilSIRENTE study.
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DOI：
10.1186/1471-2318-8-34
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发表时间：
2008-12-22
期刊：
影响因子：
4.1
通讯作者：
Landi F
中科院分区：
文献类型：
--
作者：
Cesari M;Onder G;Zamboni V;Manini T;Shorr RI;Russo A;Bernabei R;Pahor M;Landi F
身体功能测量已被证明可以预测老年人健康相关的负面事件，包括死亡率。这些功能标记可能在事件预测中与自评健康（SRH）相互作用。本研究的目的是比较身体机能测量和SRH状态对死亡率的预测价值，并检验它们之间可能的相互作用。数据来自335名年龄≥80岁（平均年龄85.6岁）的老年人，他们参加了“长寿长寿”（ilSIRENTE）研究。采用比例风险模型比较4米步行试验、短物理性能电池（SPPB）、握力、日常生活活动（ADL）量表、工具性ADL量表和SRH量表的死亡率预测值。还计算了死亡率的Kaplan-Meier生存曲线和受试者工作特征（ROC）曲线分析，以估计死亡率（单独和联合）的自变量的预测值。在24个月的随访期间（平均1.8年），研究样本中发生了71例（21.2%）事件。所有测试变量都能显著预测死亡率。身体功能测量和SRH之间没有明显的相互作用。调整潜在混杂因素后，SPPB评分是总死亡率的最强预测因子（每SD增加；HR 0.64; 95%CI 0.48-0.86）。SRH也显示出类似的预测价值（每SD增加；HR 0.76; 95%CI 0.59-0.97）。椅子站立测试是SPPB子任务中预后价值最高的。所有测试指标都能在不同程度上预测死亡率，但SPPB和SRH的结果最强。在估计死亡风险方面，椅架试验可能与完整的SPPB一样有用。
Physical function measures have been shown to predict negative health-related events in older persons, including mortality. These markers of functioning may interact with the self-rated health (SRH) in the prediction of events. Aim of the present study is to compare the predictive value for mortality of measures of physical function and SRH status, and test their possible interactions. Data are from 335 older persons aged ≥ 80 years (mean age 85.6 years) enrolled in the "Invecchiamento e Longevità nel Sirente" (ilSIRENTE) study. The predictive values for mortality of 4-meter walk test, Short Physical Performance Battery (SPPB), hand grip strength, Activities of Daily Living (ADL) scale, Instrumental ADL (IADL) scale, and a SRH scale were compared using proportional hazard models. Kaplan-Meier survival curves for mortality and Receiver Operating Characteristic (ROC) curve analyses were also computed to estimate the predictive value of the independent variables of interest for mortality (alone and in combination). During the 24-month follow-up (mean 1.8 years), 71 (21.2%) events occurred in the study sample. All the tested variables were able to significantly predict mortality. No significant interaction was reported between physical function measures and SRH. The SPPB score was the strongest predictor of overall mortality after adjustment for potential confounders (per SD increase; HR 0.64; 95%CI 0.48–0.86). A similar predictive value was showed by the SRH (per SD increase; HR 0.76; 95%CI 0.59–0.97). The chair stand test was the SPPB subtask showing the highest prognostic value. All the tested measures are able to predict mortality with different extents, but strongest results were obtained from the SPPB and the SRH. The chair stand test may be as useful as the complete SPPB in estimating the mortality risk.