Subtypes of disability in older persons over the course of nearly 8 years
Subtypes of disability in older persons over the course of nearly 8 years
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DOI：
10.1111/j.1532-5415.2007.01603.x
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发表时间：
2008-03-01
影响因子：
6.3
通讯作者：
Allore, Heather G.
中科院分区：
文献类型：
--
作者：
Gill, Thomas M.;Guo, Zhenchao;Allore, Heather G.
目的：根据残疾发作的次数和持续时间确定残疾的不同和有临床意义的亚型，并确定这些残疾亚型的发病率是否因年龄、性别或身体虚弱而不同。754名年龄在70岁及以上的社区生活居民，在日常生活的四项基本活动中最初没有残疾。残疾进行了评估，每月电话采访近8年，身体虚弱进行了评估，在全面的家庭为基础的评估，在18个月的时间间隔。五个残疾亚型的发病率确定的背景下，18个月的时间间隔在参与者中谁是非残疾的间隔开始：短暂的，短期的，长期的，复发性的，和不稳定的。最常见的亚型是短暂性残疾（占所有间期的9.7%），定义为仅持续1个月的单次残疾发作，以及长期残疾（6.9%），定义为一次或多次残疾发作，至少一次持续6个月或更长时间。大约四分之一（24.7%）的参与者有两个或两个以上的事件残疾亚型的间隔。虽然没有性别差异的发病率的任何亚型，观察到每个亚型根据年龄和身体虚弱，只有一个例外，率的差异，特别是大的长期disability.CONCLUSION：不同的残疾亚型的机制可能不同。进一步的研究是必要的，以评估五种残疾亚型的自然史，危险因素和预后。
OBJECTIVES: To characterize distinct and clinically meaningful subtypes of disability, defined based on the number and duration of disability episodes, and to determine whether the incidence of these disability subtypes differ according to age, sex, or physical frailty.DESIGN: Prospective cohort study.SETTING: Greater New Haven, Connecticut.PARTICIPANTS: Seven hundred fifty-four community-living residents aged 70 and older and initially nondisabled in four essential activities of daily living.MEASUREMENTS: Disability was assessed during monthly telephone interviews for nearly 8 years; physical frailty was assessed during comprehensive home-based assessments at 18-month intervals. The incidence of five disability subtypes was determined within the context of the 18-month intervals in participants who were nondisabled at the start of the interval: transient, short-term, long-term, recurrent, and unstable.RESULTS: Incident disability was observed in 29.8% of the 18-month intervals. The most common subtypes were transient disability (9.7% of all intervals), defined as a single disability episode lasting only 1 month, and long-term disability (6.9%), defined as one or more disability episodes, with at least one lasting 6 or more months. Approximately one-quarter (24.7%) of all participants had two or more intervals with an incident disability subtype. Although there were no sex differences in the incidence rates for any of the subtypes, differences in rates were observed for each subtype according to age and physical frailty, with only one exception, and were especially large for long-term disability.CONCLUSION: The mechanisms underlying the different disability subtypes may differ. Additional research is warranted to evaluate the natural history, risk factors, and prognosis of the five disability subtypes.