Purpose in life is associated with a reduced risk of incident disability among community-dwelling older persons.
Purpose in life is associated with a reduced risk of incident disability among community-dwelling older persons.
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DOI：
10.1097/jgp.0b013e3181d6c259
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发表时间：
2010-12
期刊：
影响因子：
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通讯作者：
Bennett DA
中科院分区：
文献类型：
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作者：
Boyle PA;Buchman AS;Bennett DA
生活目的被认为与老年人的积极健康结果有关，但其与残疾的关系尚不清楚。检验以下假设：在社区中没有痴呆症的老年人中，生活目标更大与意外残疾风险降低有关，包括日常生活基本活动和工具活动受损以及行动能力残疾。参与者来自拉什记忆和衰老项目，这是一项大型的纵向衰老临床病理研究。退休社区，老年住房设施，以及整个大芝加哥都会区的家园。所有参与者都接受了生活目的的基线评估和详细的年度临床评估，以记录事件残疾。基线时生活目的测量的平均评分为3.6（SD=0.5，范围：2 - 5）。在一系列调整了年龄、性别和教育程度的比例风险模型中，生活目标越大，日常生活基本活动的残疾风险越低（HR=0.60，95% CI 0.45，0.81），工具性日常生活活动（HR=0.56; 95% CI 0.40，0.78）和行动能力障碍（HR=0.61，95% CI 0.44，0.84）。这些关联并不沿着人口统计学线变化，并且在添加控制全局认知、抑郁症状、社交网络、神经质、收入、身体虚弱、血管风险因素和血管疾病的术语后持续存在。在无痴呆症的社区老年人中，更大的生活目标与维持功能状态有关，包括减少日常生活的基本和工具活动受损和行动不便的风险。
Purpose in life is thought to be associated with positive health outcomes in old age, but its association with disability is unknown. Test the hypothesis that greater purpose in life is associated with a reduced risk of incident disability, including impairment in basic and instrumental activities of daily living and mobility disability, among community-based older persons free of dementia. Participants were from the Rush Memory and Aging Project, a large longitudinal clinical-pathologic study of aging. Retirement communities, senior housing facilities, and homes across the greater Chicago metropolitan area. All participants underwent baseline assessment of purpose in life and detailed annual clinical evaluations to document incident disability. The mean score on the purpose in life measure at baseline was 3.6 (SD=0.5, range: 2 to 5). In a series of proportional hazards models adjusted for age, sex, and education, greater purpose in life was associated with a reduced risk of disability in basic activities of daily living (HR=0.60, 95% CI 0.45, 0.81), instrumental activities of daily living (HR=0.56; 95% CI 0.40, 0.78), and mobility disability (HR=0.61, 95% CI 0.44, 0.84). These associations did not vary along demographic lines and persisted after the addition of terms to control for global cognition, depressive symptoms, social networks, neuroticism, income, physical frailty, vascular risk factors, and vascular diseases. Among community-based older persons without dementia, greater purpose in life is associated with maintenance of functional status, including a reduced risk of developing impairment in basic and instrumental activities of daily living and mobility disability.