Chronic medical conditions and the sex-based disparity in disability: the Cardiovascular Health Study.
Chronic medical conditions and the sex-based disparity in disability: the Cardiovascular Health Study.
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DOI：
10.1093/gerona/glq139
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发表时间：
2010-12
期刊：
影响因子：
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通讯作者：
H. Whitson;L. Landerman;A. Newman;L. Fried;C. Pieper;H. Cohen
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文献类型：
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作者：
H. Whitson;L. Landerman;A. Newman;L. Fried;C. Pieper;H. Cohen
背景老年妇女比同龄男性更容易患残疾。这种差异可能部分是由于常见疾病的患病率或致残效应存在性别差异。这项分析的目的是：（a）量化在何种程度上妇女残疾过多是由于某些疾病的流行率较高所致;（B）评估同样的疾病是否对男女残疾产生不同的影响。我们分析了来自5,888名社区老年男性和女性的横断面数据。残疾的定义是有大于或等于一项日常生活活动的困难。通过自我报告、测试或记录审查评估了13种疾病。控制年龄，种族，教育和婚姻状况，女性更容易经历残疾（比值比= 1.70，95%置信区间= 1.36-2.11）。女性关节炎和肥胖症的患病率较高，分别解释了残疾率性别差异的30.2%和12.9%，而男性流行的疾病，如血管疾病和肺气肿，缩小了残疾差距。患有关节炎、听力问题、冠状动脉疾病、充血性心力衰竭、中风和跛行的女性比患有相同疾病的男性更容易出现残疾（p <0.001）。结论：减少残疾中基于性别的不平等的努力应该集中在减少关节炎和肥胖的患病率上。如果女性血管疾病和肺气肿的发病率上升，后代可能会看到更大的功能差异。有几种情况往往与妇女的残疾有关，这表明在残疾过程中存在其他基于性别的差异。
BACKGROUND Older women experience disability more commonly than their male peers. This disparity may be due, in part, to sex-based differences in the prevalence or the disabling effects of common medical conditions. The objectives of this analysis were to (a) quantify the extent to which excess disability in women is explained by higher prevalence of selected medical conditions and (b) evaluate whether the same conditions have differing effects on disability in men and women. METHODS We analyzed cross-sectional data from 5,888 community-dwelling older men and women. Disability was defined as difficulty with greater than or equal to one activity of daily living. Thirteen medical conditions were assessed by self-report, testing, or record review. RESULTS Controlling for age, race, education, and marital status, women were more likely to experience disability (odds ratio = 1.70, 95% confidence interval = 1.36-2.11). Higher prevalence of arthritis and obesity in women explained 30.2% and 12.9%, respectively, of the sex-based difference in disability rates, whereas male prevalent diseases like vascular conditions and emphysema narrowed the disability gap. Women with arthritis, hearing problems, coronary artery disease, congestive heart failure, stroke, and claudication were more likely to exhibit disability compared with men with the same conditions (p < .001). CONCLUSIONS Efforts to lessen sex-based inequality in disability should focus on reducing the prevalence of arthritis and obesity. Future generations may see greater functional disparity if rates of vascular disease and emphysema rise among women. Several conditions were more often associated with disability in women, suggesting additional sex-based differences in the disablement process.