The role of change in physical performance in determining risk for dependence in activities of daily living among nondisabled community-living elderly persons.
The role of change in physical performance in determining risk for dependence in activities of daily living among nondisabled community-living elderly persons.
复制标题
身体机能变化在确定非残疾社区生活老年人日常生活活动依赖风险中的作用。
DOI：
10.1016/s0895-4356(97)00065-6
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发表时间：
1997
影响因子：
7.2
通讯作者：
Tinetti,ME
中科院分区：
文献类型：
--
作者：
Gill,TM;Williams,CS;MendesdeLeon,CF;Tinetti,ME
在社区生活的老年人中，对身体表现的单一评估是日常生活活动（ADL）依赖性的有力预测指标。本研究的目的是确定对身体表现变化的评估是否可以提供超出单一评估所提供的有用的预后信息。在一大群有代表性的老年人中，我们评估了 586 名在基线和一年访谈中均独立于 ADL 的参与者。对于三项定时测试中的每一项，身体表现大幅下降的参与者在三年后比那些改善或没有变化的参与者更有可能出现 ADL 依赖。然而，在调整 1 年分数后，身体表现的变化不再与 ADL 依赖相关。然而，在基线访谈中独立于 ADL 的 775 名参与者中，即使在调整基线表现后，身体表现的变化与一年后 ADL 依赖的发生显着相关。在确定 ADL 依赖风险时，对一年内身体机能变化的评估并不能提供超出单次评估可用的有用预后信息。然而，身体表现的变化与同时存在的 ADL 依赖独立相关，如果在较短的时间间隔内进行测量，则可能有助于预测未来的残疾。
Among community-living elderly persons, a single assessment of physical performance is a powerful predictor of dependence in activities of daily living (ADLs). The aim of this study was to determine whether an assessment of change in physical performance provides useful prognostic information beyond that available from a single assessment. Among a large representative cohort of elderly persons, we evaluated the 586 participants who were ADL independent at both the baseline and the one year interviews. For each of the three timed tests, participants who had a large decline in physical performance were significantly more likely to develop ADL dependence at three years than those who improved or showed no change. After adjusting for 1-year scores, however, change in physical performance was no longer associated with ADL dependence. However, among the 775 participants who were ADL independent at the baseline interview, change in physical performance was significantly associated with the onset of ADL dependence at one year, even after adjusting for baseline performance. When determining risk for ADL dependence, an assessment of change in physical performance over one year does not provide useful prognostic information beyond that available from a single assessment. Nevertheless, change in physical performance is independently associated with concurrent ADL dependence and may be useful in predicting future disability if measured over shorter intervals.