DISABILITY IN THE INDIVIDUAL ADL, IADL, AND MOBILITY AMONG OLDER ADULTS: A PROSPECTIVE COHORT STUDY
DISABILITY IN THE INDIVIDUAL ADL, IADL, AND MOBILITY AMONG OLDER ADULTS: A PROSPECTIVE COHORT STUDY
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DOI：
10.1007/s12603-017-0891-6
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发表时间：
2017-10-01
影响因子：
5.8
通讯作者：
Schuurmans, M. J.
中科院分区：
文献类型：
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作者：
Bleijenberg, N.;Zuithoff, N. P. A.;Schuurmans, M. J.
目标：按年龄检查 15 名老年人的 ADL、IADL 和活动能力的残疾风险；并评估多发病、性别和教育与残疾的关系。设计与设置：一项前瞻性队列研究。该样本包括居住在荷兰的 805 名 60 岁以上社区老年人。测量：使用 Katz-15 基本日常生活活动独立指数 (ADL)、工具性日常生活活动 (IADL) 和一项行动能力项目来评估残疾情况。任何这些活动中的残疾被定义为在没有帮助的情况下无法进行活动。使用广义混合模型评估每个人的 ADL、IADL 和活动能力的年龄残疾风险。结果：家务、旅行、购物和失禁等活动中的残疾风险最高，并且随着年龄的增长而迅速增加。患有两种合并症的 65 岁人群中，旅行残疾的风险从 9% 增加到 85 岁时的 37%。使用电话、管理药物、财务、转移和如厕等方面的残疾风险非常低，几乎不会随着年龄的增长而增加。与没有慢性病的人相比，患有≥3种慢性病的人患残疾的风险高出3至5倍。男性在管理药物（P=0.005）和准备膳食（P=0.019）方面的残疾风险较高，而女性在旅行方面的残疾风险较高（P=0.001）。没有观察到教育程度与个人 ADL、IADL 和活动能力的残疾之间存在关联。结论：老年人大多在身体相关活动中出现残疾，而在与认知相关的活动中出现残疾的情况较少。多种疾病对每项活动中的残疾的影响都很大，而教育则不然。
Objectives: To examine the risk of disability in 15 individual ADL, IADL, and mobility in older adults by age; and to assess the association of multimorbidity, gender, and education with disability. Design & Setting: A prospective cohort study. The sample included 805 community-dwelling older people aged 60+ living in the Netherlands. Measurements: Disability was assessed using the Katz-15 Index of Independence in Basic Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) and one mobility item. Disability in any of these activities was defined as the inability to perform the activity without assistance. The risk of disability by age for each individual ADL, IADL, and for mobility was assessed using Generalized mixed models. Results: Disability in activities as household tasks, traveling, shopping, and continence had the highest risk and increased rapidly with age. The risk traveling disability among people aged 65 with two comorbidities increase from 9% to 37% at age 85. Disability in using the telephone, managing medications, finances, transferring, and toileting, had a very low risk and hardly increased with age. Compared to those without chronic conditions, those with >= 3 chronic conditions had a 3 to 5 times higher risk of developing disability. Males had a higher risk of disability in managing medication (P=0.005), and preparing meals (P=0.019), whereas females had a higher risk of disability with traveling (P=0.001). No association between education and disability on the individual ADL, IADL, and mobility was observed. Conclusions: Older adults were mostly disabled in physical related activities, whereas disability in more cognitive related activities was less often experienced. The impact of multimorbidity on disability in each activity was substantial, while education was not.