Exploring the natural history of intrinsic capacity impairments: longitudinal patterns in the 10/66 study.
Exploring the natural history of intrinsic capacity impairments: longitudinal patterns in the 10/66 study.
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DOI：
10.1093/ageing/afad137
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发表时间：
2023-07-01
期刊：
影响因子：
6.7
通讯作者：
Prina, Matthew
中科院分区：
文献类型：
--
作者：
Gonzalez-Bautista, Emmanuel;Llibre-Guerra, Jorge Jesus;Sosa, Ana L.;Acosta, Isaac;Andrieu, Sandrine;Acosta, Daisy;Llibre-Rodriguez, Juan de Jesus;Prina, Matthew
关键词：
内在能力（IC）是一个包含人的身体和心理能力的结构。在IC领域之间存在隐含的联系：认知，运动，营养，感觉和心理。然而，很少有人知道域的集成。调查低收入和中等收入国家IC域损伤的表现和演变模式，以及此类模式是否与不良结局相关。对10/66研究的前两波进行了二次分析（在古巴、多米尼加共和国、波多黎各、委内瑞拉、秘鲁、墨西哥和中国的八个城市和四个农村集水区进行了基于人口的调查）。我们对IC进行潜在转换分析，以发现IC域损伤的潜在状态（潜在簇）。我们评估了潜在状态与虚弱、残疾和死亡风险的纵向关联，并测试了并发和预测效度。在纳入的14，923名参与者中，四种潜在状态为：高IC（43%）、低恶化伴运动受损（17%）、高恶化不伴认知受损（22%）和高恶化伴认知受损（18%）。61%的参与者随着时间的推移而恶化，35%稳定，3%改善到更健康的状态。IC恶化的参与者比IC高的人有更高的虚弱，残疾和痴呆的风险。有很强的同时和预测效度。（死亡风险比= 4.60，95%CI 4.16; 5.09; Harrel's C = 0.73（95%CI 0.72;0.74））。一半的研究人群在基线时IC较高，大多数参与者呈恶化趋势。四种性质不同的IC状态或状态的特征是与其残疾和虚弱风险相关的低水平和高水平恶化。运动和认知障碍表现出其他趋势比心理和营养领域的潜在状态。
intrinsic capacity (IC) is a construct encompassing people’s physical and mental abilities. There is an implicit link amongst IC domains: cognition, locomotion, nutrition, sensory and psychological. However, little is known about the integration of the domains. to investigate patterns in the presentation and evolution of IC domain impairments in low-and-middle-income countries and if such patterns were associated with adverse outcomes. secondary analyses of the first two waves of the 10/66 study (population-based surveys conducted in eight urban and four rural catchment areas in Cuba, Dominican Republic, Puerto Rico, Venezuela, Peru, Mexico and China). We applied latent transition analysis on IC to find latent statuses (latent clusters) of IC domain impairments. We evaluated the longitudinal association of the latent statuses with the risk of frailty, disability and mortality, and tested concurrent and predictive validity. amongst 14,923 participants included, the four latent statuses were: high IC (43%), low deterioration with impaired locomotion (17%), high deterioration without cognitive impairment (22%), and high deterioration with cognitive impairment (18%). A total of 61% of the participants worsened over time, 35% were stable, and 3% improved to a healthier status. Participants with deteriorated IC had a significantly higher risk of frailty, disability and dementia than people with high IC. There was strong concurrent and predictive validity. (Mortality Hazard Ratio = 4.60, 95%CI 4.16; 5.09; Harrel’s C = 0.73 (95%CI 0.72;0.74)). half of the study population had high IC at baseline, and most participants followed a worsening trend. Four qualitatively different IC statuses or statuses were characterised by low and high levels of deterioration associated with their risk of disability and frailty. Locomotion and cognition impairments showed other trends than psychological and nutrition domains across the latent statuses.
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作者：
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发表时间：
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