Patterns in functioning among residents of an affordable assisted living housing facility
Patterns in functioning among residents of an affordable assisted living housing facility
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DOI：
10.1093/geront/42.2.178
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发表时间：
2002-04-01
期刊：
影响因子：
5.7
通讯作者：
Maddox, GL
中科院分区：
文献类型：
--
作者：
Fonda, SJ;Clipp, EC;Maddox, GL
目的：这是第二篇报道一个项目的文章，该项目(A)描述了低收入人群负担得起的辅助生活住房(ALH)环境中居民的纵向功能模式，以及(B)将ALH居民的功能模式与类似的低收入社区居民的功能模式进行比较。设计和方法：功能被定义为进行日常生活活动和日常生活工具性活动的能力，以及受访者死亡和住院等竞争风险的能力。比较样本选自健康和退休研究(HRS)和最古老的老年人中的资产和健康动态(AHEAD)研究。分析包括对功能模式和多项Logit模型的描述，以评估研究参与者经历每种功能模式和竞争风险的相对可能性。结果：在整个研究过程中，约42.4%的ALH居民有稳定的高功能，32.9%的居民病情恶化(如功能障碍、住院、死亡)，3%的人功能改善，6%的人表现出中到重度的损害，其余的人回到了社区。高龄居民与社区居民的功能模式比较显示，高龄居民的模式大致相似，但在某些方面较好，经社会人口学因素及健康调整；例如，高龄居民在改善、下降及死亡方面(在统计上)并无不同，但他们更有可能拥有稳定的高功能。结果表明，负担得起的ALH环境使低收入居民能够维持功能或很好地应对功能下降。与社区居住参与者的比较提供了证据，证明负担得起的ALH环境相对有利。
Purpose: This is the second article reporting a project that (a) characterized the longitudinal functional patterns of residents in an affordable, assisted living housing (ALH) milieu for low-income people and (b) compared the ALH residents' functional patterns with those for similarly low-income, community-dwelling people. Design and Methods: Functioning was defined as the ability to perform activities of daily living and instrumental activities of daily living and respondents' competing risks such as death and institutionalization. The comparison samples were selected from the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) study. The analyses involved description of functional patterns and multinomial logit models to assess the relative likelihood that study participants experienced each pattern of functioning and competing risks. Results: About 42.4% of the ALH residents had stable high functioning, 32.9% deteriorated (e.g., had increased impairment, institutionalization, death), 3% improved in functioning, 6% exhibited moderate to severe impairment throughout the study, and the remainder returned to the community. Comparison of the ALH residents' functional patterns with those of the community-dwelling respondents indicated that the ALH residents' patterns generally were similar and in some ways better, adjusting for social-demographic factors and health; for example, the ALH residents were no different (statistically) in terms of improvement, decline, and death, but they were more likely to have stable high functioning. Implications: The results suggest that the affordable ALH milieu enabled low-income residents to maintain function or cope well with functional decline. The comparison with community-dwelling participants provides evidence that the affordable ALH milieu was comparatively beneficial.