[Predictors of functional status among independent and homebound community dwelling elderly: physical, psychological, and social parameters].
[Predictors of functional status among independent and homebound community dwelling elderly: physical, psychological, and social parameters].
复制标题
[独立和居家社区居住老年人功能状态的预测因素：身体、心理和社会参数]。
DOI：
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发表时间：
2002
期刊：
影响因子：
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通讯作者：
A. Fukao
中科院分区：
文献类型：
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作者：
H. Imuta;S. Yasumura;T. Ahiko;A. Fukao
目的
本研究的目的是确定日本社区居住老年人的功能状态变化，并在为期一年的纵向研究中确定预测功能变化的身体、心理和社会因素。
方法
研究人员对居住在山形县两个城市的 65 岁及以上人群进行了为期一年的跟踪调查。卫生福利部制定的独立程度标准的采用程度有九个级别。受试者被分为独立（J 级）和居家（A 级），编号分别为 112 和 53。人口统计、身体、心理和社会变量的数据于 1997 年通过邮寄和家访期间的访谈收集。 1998年检查了死亡和功能状态的变化。
结果
随访时，1.0%的独立长者死亡。同样，居家老人中有 7.7% 死亡。对于两性和所有年龄组，基线和随访调查之间的功能状态变化相似。根据九个级别的标准，独立老年人功能状态良好和较差的比率在基线时大致相同。居家长者中，35.4%的人功能状态有所改善，14.6%的人功能状态恶化。独立老年人中，功能状态明显恶化，尤其是听力缺陷、近一年内住院、自我效能感丧失、主观健康状况一般或较差、功能能力差等。居家老年人中，失禁和自我效能感较差的情况明显恶化。
结论
当基线时的功能状态较差时，无论性别或年龄组如何，在后续调查中恶化都会很明显。功能状态的转变可能是动态的，对于居家老年人来说，改善比恶化更常见。我们的研究结果表明，提高自我效能感可以成为独立和居家老年人改善功能状态和预防功能恶化项目的有效目标。
PURPOSE
The purpose of this study was to determine changes in functional status of Japanese community-dwelling elderly, and to identify physical, psychological, and social factors that predict functional change in a 1-year longitudinal study.
METHODS
A cohort of people 65 years of age and over living in two cities in Yamagata Prefecture were followed for one year. The employed degree of independent criteria developed by the Ministry of Health and Welfare had nine levels. Subjects were classified as independent (rank J) and homebound (rank A) and numbered 112 and 53, respectively. Data on demographic, physical, psychological, and social variables were collected in 1997 by mail and interview during house visits. Death and change in functional status were checked in 1998.
RESULTS
At follow-up, 1.0% of independent elders had died. Likewise, of the homebound elderly 7.7% had died. Change in functional status between the baseline and follow-up surveys were similar for both sexes and all age groups. According to nine levels criteria, rates for a good and a poor functional status of independent elderly were much the same at the baseline. Among homebound elders, 35.4% demonstrated improvement in the functional status and 14.6% deterioration. Among independent elderly, worsening of the functional status was significantly displayed, particularly with regard to hearing deficits, hospitalization within the past one year, loss of self-efficacy, fair or poor subjective health and poor functional ability. Among homebound elderly, worsening was significantly displayed in term of incontinence and poor self-efficacy.
CONCLUSIONS
When functional status at baseline was poor, deterioration was evident at follow-up survey, independent of the sex or age group. Transition in functional status can be dynamic, and improvement was more usual than worsening among homebound elderly. Our results show that increase in self-efficacy can be an effective target in programs for improvement of functional status and for prevention of functional deterioration among the independent and homebound elderly of both sexes.