MAINTAINING MOBILITY IN LATE-LIFE .1. DEMOGRAPHIC CHARACTERISTICS AND CHRONIC CONDITIONS
MAINTAINING MOBILITY IN LATE-LIFE .1. DEMOGRAPHIC CHARACTERISTICS AND CHRONIC CONDITIONS
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DOI：
10.1093/oxfordjournals.aje.a116746
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发表时间：
1993-04-15
影响因子：
5
通讯作者：
WALLACE, RB
中科院分区：
文献类型：
--
作者：
GURALNIK, JM;LACROIX, AZ;WALLACE, RB
为了评估人口统计因素和慢性条件在维持老年人流动性方面的作用，这项研究利用了1981至1987年间作为老年流行病学研究既定人口的一部分收集的纵向数据，调查对象为6981名65岁及以上的男性和女性，他们分布在马萨诸塞州东波士顿、爱荷华州爱荷华州和华盛顿县以及康涅狄格州纽黑文市。结果给出了那些在基线时报告完整活动能力的人，这些人的定义是在没有帮助的情况下爬楼梯和走半英里的能力，并且每年跟踪调查活动状态的变化长达4年。评估年龄、收入、教育程度和在随访期间出现的慢性疾病与活动能力丧失的关系。在随访期内，55.1%的受试者保持了活动能力，36.2%的受试者失去了活动能力，8.7%的受试者死亡前没有活动能力丧失的证据。在男性和女性中，年龄增加和收入水平降低与丧失行动能力的风险增加有关，即使在控制了基线水平的慢性病之后也是如此。在对年龄、收入和慢性疾病进行调整后，较低的教育水平是男性行动不便的重要风险因素，但在女性中不是。既往心脏病发作、中风、高血压、糖尿病、呼吸困难和劳力性腿部疼痛的基线报告与活动能力丧失的小但显著的风险相关。根据基线上存在的慢性病的数量，行动不便的风险逐步增加，这在男性和女性之间非常一致。在研究期间发生新的心脏病发作、中风、癌症或髋部骨折，与基线时这些情况的存在相比，活动能力丧失的风险要大得多。
To assess the role of demographic tactors and chronic conditions in maintaining mobility in older persons, this study utilized longitudinal data collected as part of the Established Populations for Epidemiologic Studies of the Elderly between 1981 and 1987 on 6,981 men and women aged 65 years and older in East Boston, Massachusetts; Iowa and Washington counties, Iowa; and New Haven, Connecticut. Results are presented for those who at baseline reported intact mobility, defined as the ability to climb stairs and walk a half mile without help, and who were followed annually for up to 4 years for changes in mobility status. Age, income, education, and chronic conditions present at baseline and occurring during follow-up were evaluated for their association with loss of mobility. Over the follow-up period, 55.1% of subjects maintained mobility, 36.2% lost mobility, and 8.7% died without evidence of mobility loss prior to death. In both men and women, increasing age and lower income levels were associated with increased risk of losing mobility, even after controlling for the presence of chronic conditions at baseline. After adjustment for age, income, and chronic conditions, lower education levels were a significant risk factor for mobility loss in men, but not in women. Baseline reports of previous heart attack, stroke, high blood pressure, diabetes, dyspnea, and exertional leg pain were associated with small but significant risks for mobility loss. There was a stepwise increase in the risk of mobility loss according to the number of chronic conditions present at baseline that was very consistent between men and women. The occurrence during the study of a new heart attack, stroke, cancer, or hip fracture was associated with a substantially greater risk of mobility loss than was associated with the presence of these conditions at baseline.