The dynamic nature of mobility disability in older persons
The dynamic nature of mobility disability in older persons
复制标题
DOI：
10.1111/j.1532-5415.2005.00586.x
复制
发表时间：
2006-02-01
影响因子：
6.3
通讯作者：
Guo, ZC
中科院分区：
文献类型：
--
作者：
Gill, TM;Allore, HG;Guo, ZC
目的：确定行动障碍患者临床意义转变的发生率；评估这些转变如何根据年龄、性别和身体虚弱程度而有所不同；并描述由此导致的行动障碍的持续时间。设计：前瞻性队列研究。周边环境：1998年3月至2004年10月，位于康涅狄格州大纽黑文的普通社区。研究对象：754名70岁及以上非残疾（即不需要个人协助）的社区长者，参与四项日常生活活动。测量：行动不便，定义为不能在没有个人帮助的情况下分别行走四分之一英里和爬一段楼梯，每月评估一次，长达5年。结果：对于这两项活动任务，从无残疾到间歇性残疾（行走四分之一英里为34.7，爬一段楼梯为17.4），间歇到持续残疾（52.0和42.5），持续到间歇性残疾（35.4和31.5），以及间歇到无残疾（68.6和85.4）的每1000人月的比率高于其他过渡。年龄较大、女性和身体虚弱与更大的可能性过渡到更大的残疾状态和更低的可能性恢复独立行动有关。结论：老年人的行动障碍是一个高度动态的过程，其特点是在独立状态和残疾状态之间频繁过渡。旨在提高独立行动能力的项目不仅应注重预防行动障碍，还应注重恢复和维持残疾老年人的独立行动能力。
OBJECTIVES: To determine the rates of clinically meaningful transitions in mobility disability; evaluate how these transitions differ according to age, sex, and physical frailty; and depict the duration of the resulting episodes of mobility disability.DESIGN: Prospective cohort study.SETTING: General community in greater New Haven, Connecticut, from March 1998 to October 2004.PARTICIPANTS: Seven hundred fifty-four community-living older persons, aged 70 and older, who were nondisabled (i.e., required no personal assistance) in four activities of daily living.MEASUREMENTS: Mobility disability, defined as the inability to walk one quarter of a mile and to climb a flight of stairs, respectively without personal assistance, was assessed every month for up to 5 years.RESULTS: For both mobility tasks, rates per 1,000 person-months were higher for transitions from no disability to intermittent disability (34.7 for walking one quarter of a mile and 17.4 for climbing a flight of stairs), intermittent to continuous disability (52.0 and 42.5), continuous to intermittent disability (35.4 and 31.5), and intermittent to no disability (68.6 and 85.4) than for other transitions. Older age, female sex, and physical frailty were associated with greater likelihood of transition to states of greater disability and lower likelihood of regaining independent mobility.CONCLUSION: Mobility disability in older persons is a highly dynamic process, characterized by frequent transitions between states of independence and disability. Programs designed to enhance independent mobility should focus not only on the prevention of mobility disability but also on the restoration and maintenance of independent mobility in older persons who become disabled.