THE DYNAMICS OF DISABILITY AND FUNCTIONAL CHANGE IN AN ELDERLY COHORT - RESULTS FROM THE ALAMEDA COUNTY STUDY
THE DYNAMICS OF DISABILITY AND FUNCTIONAL CHANGE IN AN ELDERLY COHORT - RESULTS FROM THE ALAMEDA COUNTY STUDY
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DOI：
10.1111/j.1532-5415.1992.tb01852.x
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发表时间：
1992-08-01
影响因子：
6.3
通讯作者：
COHEN, RD
中科院分区：
文献类型：
--
作者：
STRAWBRIDGE, WJ;KAPLAN, GA;COHEN, RD
目的：在老年人的代表性样本中，通过年龄、性别和种族来检查功能状态随时间的变化。设计：6年前瞻性队列研究。环境：加利福尼亚州阿拉米达县。参与者：1984年基线时508名65岁及以上的人。主要结果测量：日常生活活动（ADL）依赖、行动障碍和功能（18项量表）。结果：基线时ADL依赖和活动障碍的患病率随着年龄的增长而增加，而功能下降。在80岁及以上的人群中，差异尤为显著。在6年的随访中，功能的变化也显示出类似的模式。虽然男性的死亡率较高，但女性的初始功能较差，存活的女性比存活的男性下降得更多。在随访期间，男性和女性的ADL依赖和活动障碍的发生率相似，尽管女性在偶发性残疾中存活的时间比男性长。黑人的基线功能较差，ADL依赖性和活动障碍较多，随访期间下降幅度大于非黑人。黑人和非黑人之间的一些基本功能差异是由于慢性病和合并症的发生率较高。尽管在过去6年中，功能总体呈下降趋势，但13%的男性和20%的女性有所改善。结论：老年人与年龄相关的功能变化是复杂的，具有很大的异质性。澄清这种异质性的原因是一个重要且具有挑战性的研究领域。
Objective: To examine changes in functional status over time by age, gender, and ethnicity in a representative sample of older persons.Design: Six-year prospective cohort study.Setting: Alameda County, California.Participants: 508 persons 65 years old and older at baseline in 1984.Main Outcome Measures: Activities of daily living (ADL) dependence, mobility impairment, and functioning on an 18-item scale.Results: The prevalence of ADL dependence and mobility impairment at baseline increased with age, while function decreased. Particularly striking differences occurred for those 80 and older. Changes in function over the 6-year follow-up showed a similar pattern. While death rates for males were higher, females had poorer initial functioning, and surviving females declined more than surviving males. The incidence of ADL dependence and mobility impairment during follow-up was similar for males and females, although females survived longer with incident disability than did males. Blacks had poorer baseline functioning, more ADL dependence and mobility impairment, and declined more than non-Blacks during follow-up. Some of the baseline difference in function between Blacks and non-Blacks was due to higher rates of chronic illness and co-morbidity. In spite of the general downward trend in functioning over the 6 years, 13% of the males and 20% of the females improved.Conclusion: Age-related changes in function for older persons are complex and result in much heterogeneity. Clarifying the reasons for such heterogeneity is an important and challenging area of research.