Socioeconomic Inequalities in Frailty among Older Adults: Results from a 10-Year Longitudinal Study in the Netherlands
Socioeconomic Inequalities in Frailty among Older Adults: Results from a 10-Year Longitudinal Study in the Netherlands
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DOI：
10.1159/000481943
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发表时间：
2018-01-01
期刊：
影响因子：
3.5
通讯作者：
Huisman, Martijn
中科院分区：
文献类型：
--
作者：
Hoogendijk, Emiel O.;Heymans, Martijn W.;Huisman, Martijn
背景：虚弱是老年人不良结局的一个重要危险因素。社会经济群体之间的虚弱患病率存在很大差异，但社会经济地位（SEP）和虚弱之间的关联的纵向证据很少。目的：调查10年随访期间老年人脆弱的社会经济不平等的过程。方法：数据来自阿姆斯特丹纵向老化研究（n = 1，509）。虚弱是用功能域方法测量的，基于四个领域的缺陷：身体，营养，认知和感觉。在10年的随访中，进行混合模型分析以估计虚弱的病程及其与SEP的相关性。我们调查了在不同情景下是否存在相似的关联模式，将幸存者分析的结果与基于两种归因于死亡的辍学的插补方法（替换第一个缺失值和用预测模型插补的缺失值）的结果进行比较。结果如下：所有的情况都显示出随着年龄的增长，（生存者分析OR = 1.87，95%CI = 1.66-2.11）以及低教育和低收入与虚弱的关系（低学历调整后OR = 1.76，95% CI = 1.05-2.97;低收入调整后OR = 1.90，95% CI = 1.20-3.01;均用于幸存者分析）。按性别分层的分析表明，社会经济不平等主要存在于男子，而不是妇女。在所有的情况下，SEP与虚弱的关联模式相似，但随着时间的推移，虚弱患病率的增加在不同的情况下有很大的不同。时间和SEP对虚弱（所有情况）的相互作用无统计学意义，表明在随访期间虚弱的不平等没有增加或减少。结论：SEP的不平等，在老年人中，主要是男性，并持续在10年的随访。(c)2017作者（s）由S. Karger AG，巴塞尔
Background: Frailty is an important risk factor for adverse outcomes in older people. Substantial variation in frailty prevalence between socioeconomic groups exists, but longitudinal evidence for the association between socioeconomic position (SEP) and frailty is scarce. Objective: To investigate the course of socioeconomic inequalities in frailty among older adults during 10 years of follow-up. Methods: Data were used from the Longitudinal Aging Study Amsterdam (n = 1,509). Frailty was measured with the functional domains approach, based on deficiencies in four domains: physical, nutritive, cognitive, and sensory. Mixed-model analyses were performed to estimate the course of frailty and its association with SEP during a 10-year follow-up. We investigated whether similar patterns of associations held in different scenarios, comparing results of survivor analyses with those based on two imputation methods accounting for dropout due to death (substitution of first missing value and missing values imputed with a prediction model). Results: All scenarios showed a linear increase in frailty with aging (survivor analyses OR = 1.87, 95% CI = 1.66-2.11) and associations of low education and low income with frailty (adjusted OR for low education = 1.76, 95% CI = 1.05-2.97; adjusted OR for low income = 1.90, 95% CI = 1.20-3.01; both for survivor analyses). Sex-stratified analyses indicated that socioeconomic inequalities were mainly present in men, not in women. Similar patterns of associations of SEP with frailty were observed in all scenarios, but the increase in frailty prevalence over time differed substantially between the scenarios. There were no statistically significant interactions between time and SEP on frailty (all scenarios), suggesting that inequalities in frailty did not increase or decrease during follow-up. Conclusion: SEP inequalities in frailty among older adults were observed, mainly among men, and persisted during 10 years of follow-up. (c) 2017 The Author(s) Published by S. Karger AG, Basel