Community-level socio-economic status and cognitive and functional impairment in the older population
Community-level socio-economic status and cognitive and functional impairment in the older population
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DOI：
10.1093/eurpub/ckm076
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发表时间：
2008-02-01
影响因子：
4.4
通讯作者：
Brayne, Carol
中科院分区：
文献类型：
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作者：
Basta, Nicole E.;Matthews, Fiona E.;Brayne, Carol
背景：这项研究旨在确定，即使在控制了个人社会经济地位的影响后，生活在社会经济贫困程度较高的社区的人是否仍面临认知和功能障碍风险的增加。方法：我们分析了医学研究理事会认知功能和老龄化研究的横断面数据，该研究包括剑桥郡、格温内德、纽卡斯尔、诺丁汉和牛津的社区样本。这项研究包括13004名年龄在65岁及以上的男性和女性，他们是从家庭健康服务管理局计算机化的记录中随机挑选出来的，经过分层，以确保75岁及以上的人和75岁以下的人的数量相等。结果测量结果为认知障碍(简明智力状态检查0-21)和功能障碍(日常生活工具活动和/或日常生活残疾活动)。结果：在控制了年龄、性别、中心效应、教育程度和社会阶层等因素后，生活在较贫困地区的个体有较高的认知功能障碍[优势比(OR)(最贫穷与最少剥夺五分位数)=2.3；95%可信区间(CI)1.8~3.0；P<；0.001]和功能障碍[OR(最贫穷与最少)=1.6；95%CI 1.4~1.9；P<；0.001]。结论：生活在社会经济贫困地区的老年人，无论其社会经济地位如何，其认知障碍和功能障碍的患病率都明显较高。这一证据对于公共卫生政策和那些为老年人的长期护理分配资源的人具有重要意义。
Background: This study aimed to determine if people living in communities with higher socio-economic deprivation are at an increased risk of cognitive and functional impairment even after controlling for the effects of individual socio-economic status. Methods: We analysed cross-sectional data from the Medical Research Council Cognitive Function and Ageing Study which consists of a community-based sample of Cambridgeshire, Gwynedd, Newcastle, Nottingham and Oxford. The study included 13004 men and women aged 65 years and over who were randomly selected from Family Health Services Authority computerized records after being stratified to ensure equal numbers of those aged 75 years and over and those under 75 years. The outcome measures were cognitive impairment (Mini-Mental State Exam 0-21) and functional impairment (Instrumental Activities of Daily Living and/or Activities of Daily Living disability). Results: Individuals living in more deprived areas, as measured by the Townsend deprivation score, were found to have a higher prevalence of cognitive impairment [odds ratio (OR) (most deprived versus least deprived quintile) = 2.3; 95% confidence interval (CI)1.8-3.0; P < 0.001] and functional impairment [OR (most deprived versus least) = 1.6; 95% CI 1.4-1.9; P < 0.001] after controlling for age, sex, centre effects, education and social class. Conclusions: There is a significantly higher prevalence of cognitive impairment and functional impairment in elderly individuals living in socio-economically deprived areas regardless of their own socio-economic status. This evidence is of relevance for informing public health policy and those allocating resources for the long-term care of the elderly.