Aging, health risks, and cumulative disability
Aging, health risks, and cumulative disability
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DOI：
10.1056/nejm199804093381506
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发表时间：
1998-04-09
影响因子：
158.5
通讯作者：
Fries, JF
中科院分区：
文献类型：
--
作者：
Vita, AJ;Terry, RB;Fries, JF
背景：健康风险较低的人往往比健康风险较高的人寿命更长，但人们一直担心，寿命延长可能带来更大的残疾。我们进行了一项纵向研究，以确定潜在可改变健康风险较低的人是否有更多或更少的累积残疾。方法从1962年开始调查1741名大学校友（平均年龄43岁），从1986年开始每年调查一次，根据吸烟、身体质量指数和运动模式划分高、中、低风险阶层。累积残疾是通过健康评估问卷来确定的，并在0到3的范围内打分。1986年至1994年的累积残疾（1994年的平均年龄为75岁）或死亡是终生残疾的衡量标准。结果1962年和1986年高危险度人群的累积失能是低危险度人群的2倍（失能指数1.02 vs 0.49, P < 0.001）。在过去一年和过去两年的观察中，幸存者、死者、男性和女性的结果都是一致的。与高风险组相比，低风险组的残疾发作时间推迟了五年以上。在最后一至两年的观察中，死亡的低危受试者的残疾指数是高危受试者的一半。结论吸烟、身体质量指数和中年和成年后期的运动模式是随后残疾的预测因素。拥有良好卫生习惯的人不仅活得更久，而且在这些人中，残疾被推迟并压缩到生命结束时的更短时间内。(C) 1998年，马萨诸塞州医学协会。
Background Persons with lower health risks tend to live longer than those with higher health risks, but there has been concern that greater longevity may bring with it greater disability. We performed a longitudinal study to determine whether persons with lower potentially modifiable health risks have more or less cumulative disability.Methods We studied 1741 university alumni who were surveyed first in 1962 (average age, 43 years) and then annually starting in 1986, Strata of high, moderate, and low risk were defined on the basis of smoking, body-mass index, and exercise patterns. Cumulative disability was determined with a health-assessment questionnaire and scored on a scale of 0 to 3. Cumulative disability from 1986 to 1994 (average age in 1994, 75 years) or death was the measure of lifetime disability.Results Persons with high health risks in 1962 or 1986 had twice the cumulative disability of those with low health risks (disability index, 1.02 vs. 0.49; P < 0.001). The results were consistent among survivors, subjects who died, men, and women and for both the last year and the last two years of observation. The onset of disability was postponed by more than five years in the low-risk group as compared with the high-risk group. The disability index for the low-risk subjects who died was half that for the high-risk subjects in the last one or two years of observation.Conclusions Smoking, body-mass index, and exercise patterns in midlife and late adulthood are predictors of subsequent disability. Not only do persons with better health habits survive longer, but in such persons, disability is postponed and compressed into fewer years at the end of life. (C) 1998, Massachusetts Medical Society.