Associations Between Geriatric Syndromes and Mortality in Community-Dwelling Elderly: Results of a National Longitudinal Study in Taiwan
Associations Between Geriatric Syndromes and Mortality in Community-Dwelling Elderly: Results of a National Longitudinal Study in Taiwan
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DOI：
10.1016/j.jamda.2016.09.017
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发表时间：
2017-03-01
影响因子：
7.6
通讯作者：
Chang, Chia-Ming
中科院分区：
文献类型：
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作者：
Huang, Chi-Chang;Lee, Jenq-Daw;Chang, Chia-Ming
目的：虽然老年综合征已被广泛研究，但它们之间的相互作用及其对预期寿命的累积影响却很少被讨论。本研究探讨老年综合征及其累积效应是否与社区居住的老年人死亡风险相关。方法：数据收集自2003年台湾老龄化纵向研究，参与者的生存状况，直到2007年12月31日。共有2744名年龄≥ 65岁的参与者被纳入这项回顾性队列研究; 634人在随访期间死亡。评估人口统计学因素、合并症、健康行为和老年综合征，包括体重不足、福尔斯、功能障碍、抑郁状况和认知障碍。采用考克斯比例风险回归分析，根据累积的老年综合征例数估计生存概率的风险比（HR）和95%可信区间（CI）。死亡率与年龄≥ 75岁、男性、教育≥ 6年、中风史、恶性肿瘤史、吸烟、不饮酒和不经常锻炼显著相关。老年综合征，如体重不足，功能障碍和抑郁状况，有助于死亡的风险。老年综合征的累积模型也预测了较高的死亡风险（N ≥ 1，HR 1.50，95% CI 1.19-1.89; N ≥ 2，HR 1.69，95% CI 1.25-2.29; N ≥ 3，HR 2.43，95% CI 1.62-3.66）。男性、文盲、接受机构护理、体重不足、抑郁、功能受损和健康行为不良的社区老年人更有可能有较高的死亡风险。老年综合征的识别可能有助于改善社区居住的老年人的综合护理。(C)2016年AMDA -急性后和长期护理医学协会。
Objective: Although geriatric syndromes have been studied extensively, their interactions with one another and their accumulated effects on life expectancy are less frequently discussed. This study examined whether geriatric syndromes and their cumulative effects are associated with risks of mortality in community-dwelling older adults.Methods: Data were collected from the Taiwan Longitudinal Study in Aging in 2003, and the participant survival status was followed until December 31, 2007. A total of 2744 participants aged >= 65 years were included in this retrospective cohort study; 634 died during follow-up. Demographic factors, comorbidities, health behaviors, and geriatric syndromes, including underweight, falls, functional impairment, depressive condition, and cognitive impairment, were assessed. Cox proportional hazard regression analysis was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the probability of survival according to the cumulative number of geriatric syndromes.Results: The prevalence of geriatric syndromes increased with age. Mortality was significantly associated with age >= 75 years; male sex; >= 6 years of education; history of stroke, malignancy; smoking; not drinking alcohol; and not exercising regularly. Geriatric syndromes, such as underweight, functional disability, and depressive condition, contributed to the risk of mortality. The accumulative model of geriatric syndromes also predicted higher risks of mortality (N >= 1, HR 1.50, 95% CI 1.19-1.89; N >= 2, HR 1.69, 95% CI 1.25-2.29; N >= 3, HR 2.43, 95% CI 1.62-3.66).Conclusions: Community-dwelling older adults who were male, illiterate, receiving institutional care, underweight, experiencing a depressive condition, functionally impaired, and engaging in poor health behavior were more likely to have a higher risk of mortality. The identification of geriatric syndromes might help to improve comprehensive care for community-dwelling older adults. (C) 2016 AMDA - The Society for Post-Acute and Long-Term Care Medicine.