Activities of daily living dependency and disease-specific mortality during 12-year follow-up in an 80-year-old population
Activities of daily living dependency and disease-specific mortality during 12-year follow-up in an 80-year-old population
复制标题
80 岁人群 12 年随访期间的日常生活依赖活动和疾病特异性死亡率
DOI：
10.1007/s40520-013-0029-6
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发表时间：
2013
影响因子：
4
通讯作者：
Sonoki K
中科院分区：
文献类型：
--
作者：
Takata Y;Ansai T;Soh I;Awano S;Nakamichi I;Akifusa S;Goto K;Yoshida A;Sonoki K
背景和目的尽管老年人身体虚弱或日常生活活动能力受损（ADL）的总死亡率可能更高，但对老年人疾病特异性死亡率与ADL依赖之间的关系知之甚少。因此，我们研究了80岁人群的12年疾病特异性死亡率是否与ADL依赖相关。方法1998年对日本福冈县1282名社区居民进行调查，其中824人（64.3%）（男性309人，女性515人）参加调查，其余458人未参加调查，在基线调查后对其死亡情况和死因进行了12年的随访。ADL依赖程度根据日本厚生劳动省的残疾老年人指南确定，ADL依赖程度仅在基线时测量。结果随访12年，死亡506例，未死亡276例，失踪42例。在506名死者中，128人死于心血管疾病，96人死于呼吸道疾病，87人死于癌症，51人死于衰老。将受试者分为ADL-1组（独立组，n= 600）、ADL-2组（几乎独立组，n= 113）、ADL-3组（依赖组，n= 93）。在调整各种混杂因素后，ADL-3组的总因死亡率是ADL-3组的2.8倍，呼吸系统疾病死亡率是ADL-3组的4.1倍，衰老死亡率是ADL-1组的5.7倍。癌症或心血管疾病导致的死亡率与ADL依赖性之间没有关联。结论：我们发现ADL依赖与全因死亡率、呼吸系统疾病或衰老之间存在独立关联，但与癌症或心血管疾病死亡率无关。这些结果表明，改善ADL依赖性可以降低所有死亡率和呼吸系统疾病或衰老引起的死亡率。
Background and aimsAlthough total mortality is likely to be higher in elderly individuals with frailty or impaired activities of daily living (ADL), little is known about the relationships between disease-specific mortality and ADL dependency in the elderly. Therefore, we examined whether 12-year disease-specific mortality may be associated with ADL dependency in an 80-year-old population.MethodsIn 1998, of 1,282 community-dwelling residents of Japan’s Fukuoka Prefecture, 824 (64.3 %) (309 males and 515 females) participated, the remaining 458 subjects did not participate, and their deaths and causes of death were followed up for 12 years after the baseline examination. ADL dependency was determined according to the guidelines for disabled elderly from the Health, Labor, and Welfare Ministry of Japan, and ADL dependency was measured only at baseline.ResultsDuring the 12-year follow-up, 506 died, 276 did not die, and 42 were lost. Of the 506 who died, 128 died due to cardiovascular disease, 96 to respiratory tract disease, 87 to cancer, and 51 to senility. The subjects were classified into three groups as follows: ADL-1 (independent group,n= 600), ADL-2 (almost-independent group,n= 113), and ADL-3 (dependent group,n= 93).Total-cause mortality was 2.8 times higher in ADL-3 subjects, respiratory disease mortality was 4.1 times higher in ADL-3 subjects, and senility mortality was 5.7 times higher in ADL-3 subjects than in ADL-1 subjects, after adjusting for various confounding factors. There was no association between mortality due to cancer or cardiovascular disease and ADL dependency.ConclusionsWe found an independent association between ADL dependency and mortality due to all causes, respiratory disease or senility, but no association with mortality due to cancer or cardiovascular disease. These findings suggest that improving ADL dependency may reduce all mortality and mortality due to respiratory disease or senility.