Cohort differences in disease and disability in the young-old: findings from the MRC Cognitive Function and Ageing Study (MRC-CFAS)
Cohort differences in disease and disability in the young-old: findings from the MRC Cognitive Function and Ageing Study (MRC-CFAS)
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DOI：
10.1186/1471-2458-7-156
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发表时间：
2007-07-13
影响因子：
4.5
通讯作者：
Brayne, Carol
中科院分区：
文献类型：
--
作者：
Jagger, Carol;Matthews, Ruth J.;Brayne, Carol
背景：健康和社会护理需求的预测对健康和残疾队列趋势的假设高度敏感。我们使用来自英国医学研究委员会认知功能和老龄化研究剑桥郡中心的重复人群为基础的横断面研究来调查英国年轻-老年人口的健康趋势。方法：比较1991/2 （n = 689）和1996/7 (n = 687) 65-69岁男性和女性的非重叠队列：自我报告的疾病和状况；自我报告健康;流动的限制;残疾采用逻辑回归，四年生存率采用Cox比例风险回归模型，并对社会经济和生活方式因素的差异进行了调整。结果：组间生存率相似（HR: 0.91, 95% CI: 0.62 ~ 1.32）。队列间报告的疾病数量显著增加，新队列中报告3种或3种以上疾病的参与者更多（14.2%对10.1%）。当考虑到个体情况时，报告关节炎的人数增加了10%，报告慢性气道阻塞的人数显著增加（OR: 1.36, 95% CI: 1.04至1.78）。结论：这项研究提供了证据表明，在年轻老年人的新队列中，通过自我报告的慢性病患病率来衡量，不健康水平正在上升。虽然目前还不能排除疾病诊断或报告方面的变化，以便更好地了解我们的研究结果是否反映了不健康状况的真正增加，但应该投资于改进的基于人口的数据库，将自我报告与健康和功能的客观测量联系起来，并包括长期护理。
Background: Projections of health and social care need are highly sensitive to assumptions about cohort trends in health and disability. We use a repeated population-based cross-sectional study from the Cambridgeshire centre of the UK Medical Research Council Cognitive Function and Ageing Study to investigate trends in the health of the young-old UK populationMethods: Non-overlapping cohorts of men and women aged 65-69 years in 1991/2 (n = 689) and 1996/7 (n = 687) were compared on: self-reported diseases and conditions; self-rated health; mobility limitation; disability by logistic regression and four-year survival by Cox Proportional Hazards Regression models, with adjustments for differences in socio-economic and lifestyle factors.Results: Survival was similar between cohorts (HR: 0.91, 95% CI: 0.62 to 1.32). There was a significant increase in the number of conditions reported between cohorts, with more participants reporting 3 or more conditions in the new cohort (14.2% vs. 10.1%). When individual conditions were considered, there was a 10% increase in the reporting of arthritis and a significant increase in the reporting of chronic airways obstruction (OR: 1.36, 95% CI: 1.04 to 1.78).Conclusion: This study provides evidence of rising levels of ill-health, as measured by the prevalence of self-reported chronic conditions, in the newer cohorts of the young-old. Though changes in diagnosis or reporting of disease cannot, as yet, be excluded, to better understand whether our findings reflect real increases in ill-health, investment should be made into improved population-based databases, linking self-report and objective measures of health and function, and including those in long-term care.