Socioeconomic status and improvement in functional ability among older adults in Japan: a longitudinal study
Socioeconomic status and improvement in functional ability among older adults in Japan: a longitudinal study
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DOI：
10.1186/s12889-019-6531-9
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发表时间：
2019-02-19
影响因子：
4.5
通讯作者：
Kondo, Katsunori
中科院分区：
文献类型：
--
作者：
Amemiya, Airi;Kondo, Naoki;Kondo, Katsunori
从功能残疾状态中恢复是老年人公共卫生措施的一个重要目标。本研究旨在探讨社会经济不平等对老年人功能能力改善的影响，这些老年人按基线残疾水平分层。方法在日本老年学评估研究中，我们对2010-2014年发生功能障碍的社区居住老年人（1937名男性和2212名女性）进行了邮件调查。调查数据分别与基于公共长期护理保险系统的功能性残疾水平变化的纵向记录相关联。结果平均（标准差）随访时间为316 (269)d。在随访期间，811名参与者（19.5%）的功能能力有所改善。在基线时严重残疾的患者中，受教育年限在13年及以上的男性比受教育年限在9年及以下的男性更有可能改善功能能力（风险比：1.97,95%可信区间：1.12-3.45）。在女性中也观察到类似的关联（风险比：2.16,95%可信区间：1.03-4.53）。从统计上看，收入和职业都与功能能力的提高无关。结论在功能能力的提高方面存在教育不平等，尤其是在重度残疾的老年人中。卫生政策制定者和从业人员在制定改善功能下降个体的策略时应考虑其教育背景。
BackgroundRecovery from functionally disabled status is an important target of public health measures for older adults. This study aimed to examine socioeconomic inequalities in the improvement of functional ability among older adults stratified by the level of disability at baseline.MethodsIn the Japan Gerontological Evaluation Study, we conducted a mail survey of community-dwelling older adults (1937 men and 2212 women) who developed functional impairment during 2010-2014. The survey data were individually linked to the longitudinal records of changes in the levels of functional disability based on the Public Long-Term Care Insurance System.ResultsThe mean (standard deviation) follow-up period was 316 (269) days. During follow-up, 811 participants (19.5%) showed improved functional ability. Among those with severe disabilities at baseline, men with 13 or more years of education were more likely to improve functional ability than men with 9 or fewer years of education (hazard ratio: 1.97, 95% confidence interval: 1.12-3.45). A similar association was observed among women (hazard ratio: 2.16, 95% confidence interval: 1.03-4.53). Neither income nor occupation was statistically associated with improved functional ability.ConclusionsThere are education-related inequalities in the improvement of functional ability, especially among older adults with severe disabilities. Health policy makers and practitioners should consider the educational background of individuals with reduced functionality in formulating strategies to improve their functional ability.