Improvement in usual gait speed predicts better survival in older adults
Improvement in usual gait speed predicts better survival in older adults
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DOI：
10.1111/j.1532-5415.2007.01413.x
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发表时间：
2007-11-01
影响因子：
6.3
通讯作者：
Studenski, Stephanie A.
中科院分区：
文献类型：
--
作者：
Hardy, Susan E.;Perera, Subashan;Studenski, Stephanie A.
目的：评估健康和身体功能指标1年的改善与8年存活率之间的关系。设计：前瞻性队列研究。设置：医疗保险健康维护组织和退伍军人事务部初级保健计划。伙伴：65岁及以上人群(N=439)。测量：在基线和季度评估健康和功能的六项指标。使用有意义变化的先验定义，参与者被分为一年后改善、暂时改善或从未改善：步态速度(通常步行速度超过4米)，0.1m/S；短身体表现电池，1分；医疗结果研究36项简短健康调查身体功能，10分；EuroQol，0.1分；国民健康访谈活动日常生活量表，2分；全球健康变化，两级或达到上限。死亡率是根据国家死亡指数确定的。协变量包括人口统计学、合并症、认知功能和住院时间。结果：在这六项指标中，只有步态速度改善与生存相关。步速改善组、暂时性改善组和从未改善组8年后死亡率分别为31.6%、41.2%和49.3%。调整协变量后，1年后生存改善的益处持续存在(危险比=0.42，95%可信区间=0.29~0.61，P
OBJECTIVES: To estimate the relationship between 1-year improvement in measures of health and physical function and 8-year survival.DESIGN: Prospective cohort study.SETTING: Medicare health maintenance organization and Veterans Affairs primary care programs.PARTICIPANTS: Persons aged 65 and older (N=439).MEASUREMENTS: Six measures of health and function assessed at baseline and quarterly over 1 year. Participants were classified as improved at 1 year, transiently improved, or never improved for each measure using a priori definitions of meaningful change: gait speed (usual walking pace over 4 m), 0.1 m/s; Short Physical Performance Battery, 1 point; Medical Outcomes Study 36-item Short Form Health Survey physical function, 10 points; EuroQol, 0.1 point; National Health Interview activity of daily living scale, 2 points; and global health change, two levels or reaching the ceiling. Mortality was ascertained from the National Death Index. Covariates included demographics, comorbidity, cognitive function, and hospitalization.RESULTS: Of the six measures, only improved gait speed was associated with survival. Mortality after 8 years was 31.6%, 41.2%, and 49.3% for those with improved, transiently improved, and never improved gait speed, respectively. The survival benefit for improvement at 1 year persisted after adjustment for covariates (hazard ratio=0.42, 95% confidence interval=0.29-0.61, P