Trends in US older adult disability: exploring age, period, and cohort effects.
Trends in US older adult disability: exploring age, period, and cohort effects.
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DOI：
10.2105/ajph.2011.300602
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发表时间：
2012-11
影响因子：
12.7
通讯作者：
Masters RK
中科院分区：
文献类型：
--
作者：
Lin SF;Beck AN;Finch BK;Hummer RA;Masters RK
我们阐明了在过去的30年里，美国老年残疾患病率是如何变化的。本研究采用年龄-时期-队列（APC）模型，对1982年至2009年间参加全国健康访谈调查的70岁及以上老年人的日常生活活动（ADL）和工具性日常生活活动（IADL）残疾趋势进行了研究。我们对ADL和IADL残疾以及3种APC趋势中的每一种进行了logistic回归拟合，采用2种模型：未调整和完全调整年龄、时期、队列和社会人口变量。未调整期和调整期趋势均显示ADL残疾显著下降，ADL残疾随时间变化保持稳定。两种结果未经调整的队列趋势也显示在连续队列中持续下降；然而，在调整后的模型中，增加的队列趋势很明显。由于老龄化和经期的影响，最近的美国老年人群体正变得越来越残疾。ADL和IADL残疾的净上升趋势仍未得到解释。进一步的研究应该探索导致美国老年人中基于队列的残疾增加的特定队列决定因素。
We elucidated how US late-life disability prevalence has changed over the past 3 decades. We examined activities of daily living (ADL) and instrumental activities of daily living (IADL) disability trends by using age–period–cohort (APC) models among older adults aged 70 years or older who responded to the National Health Interview Survey between 1982 and 2009. We fitted logistic regressions for ADL and IADL disabilities and for each of the 3 APC trends with 2 models: unadjusted and fully adjusted for age, period, cohort, and sociodemographic variables. The unadjusted and adjusted period trends showed a substantial decline in IADL disability, and ADL disability remained stable across time. Unadjusted cohort trends for both outcomes also showed continual declines across successive cohorts; however, increasing cohort trends were evident in the adjusted models. More recent cohorts of US older adults are becoming more disabled, net of aging and period effects. The net upward cohort trends in ADL and IADL disabilities remain unexplained. Further studies should explore cohort-specific determinants contributing to the increase of cohort-based disability among US older adults.