Association of Chronic Diseases and Impairments With Disability in Older Adults A Decade of Change?
Association of Chronic Diseases and Impairments With Disability in Older Adults A Decade of Change?
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DOI：
10.1097/mlr.0b013e318245a0e0
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发表时间：
2012-06-01
期刊：
影响因子：
3
通讯作者：
Siu, Albert L.
中科院分区：
文献类型：
--
作者：
Hung, William W.;Ross, Joseph S.;Siu, Albert L.
背景资料：关于老年人慢性疾病、损伤和残疾之间的关系如何随着时间的推移而发生变化，目前还知之甚少。目的：研究慢性疾病和损伤与特定残疾之间的关系如何随着时间的推移而发生变化。研究设计：对健康与退休研究最近的3次浪潮进行重复的横断面分析，然后使用时间相互作用变量检查整理的样本。受试者包括1998年、2004年和2008年的10，390名、10，621名和10，557名65岁及以上的社区居民。测量：基于调查的慢性病史，包括高血压、心脏病、心力衰竭、中风、糖尿病、癌症、慢性肺病和关节炎;损伤，包括认知、视力和听力;结果：随着时间的推移，慢性疾病和功能障碍与残疾的关系基本上没有变化，但高血压与复杂ADL残疾之间的关系从1998年到2004年和2008年减弱[比值比（OR）= 1.24; 99%置信区间（CI），1.06-1.46; OR = 1.07; 99% CI，0.90-1.27; OR = 1.00; 99% CI，0.83-1.19]，与高血压和自理能力障碍相同（OR = 1.32; 99%CI，1.13-1.54; OR= 0.97; 99%CI，0.82-1.14; OR = 0.99; 99%CI，0.83-1.17）。从1998年到2004年和2008年，糖尿病与自我护理能力障碍之间的联系有所加强（OR = 1.21; 99% CI，1.01-1.46; OR = 1.37; 99% CI，1.15-1.64; OR = 1.52; 99%CI，1.29-1.79），肺部疾病和自理能力也是如此（OR = 1.64; 99%CI，1.33-2.03; OR = 1.63; 99%CI，1.32-2.01; OR = 2.11; 99%CI，1.73-2.57）。虽然疾病、损伤和残疾之间的关系基本上没有变化，残疾与高血压的关联减少，与糖尿病和肺病的关联增加。
Background: Little is known about how the relationship between chronic disease, impairment, and disability has changed over time among older adults.Objective: To examine how the associations of chronic disease and impairment with specific disability have changed over time.Research Design: Repeated cross-sectional analysis, followed by examining the collated sample using time interaction variables, of 3 recent waves of the Health and Retirement Study.Subjects: The subjects included 10,390, 10,621 and 10,557 community-dwelling adults aged 65 years and above in 1998, 2004, and 2008.Measurements: Survey-based history of chronic diseases including hypertension, heart disease, heart failure, stroke, diabetes, cancer, chronic lung disease, and arthritis; impairments, including cognition, vision, and hearing; and disability, including mobility, complex activities of daily living (ADL), and self-care ADL.Results: Over time, the relationship of chronic diseases and impairments with disability was largely unchanged; however, the association between hypertension and complex ADL disability weakened from 1998 to 2004 and 2008 [odds ratio (OR) = 1.24; 99% confidence interval (CI), 1.06-1.46; OR = 1.07; 99% CI, 0.90-1.27; OR = 1.00; 99% CI, 0.83-1.19, respectively], as it did for hypertension and self-care disability (OR = 1.32; 99% CI, 1.13-1.54; OR= 0.97; 99% CI, 0.82-1.14; OR = 0.99; 99% CI, 0.83-1.17). The association between diabetes and self-care disability strengthened from 1998 to 2004 and 2008 (OR = 1.21; 99% CI, 1.01-1.46; OR = 1.37; 99% CI, 1.15-1.64; OR = 1.52; 99% CI, 1.29-1.79), as it also did for lung disease and self-care disability (OR = 1.64; 99% CI, 1.33-2.03; OR = 1.63; 99% CI, 1.32-2.01; OR = 2.11; 99% CI, 1.73-2.57).Conclusions: Although relationships between diseases, impairments, and disability were largely unchanged, disability became less associated with hypertension and more with diabetes and lung disease.