Impaired Higher-Level Functional Capacity as a Predictor of Stroke in Community-Dwelling Older Adults: The Ohasama Study.
Impaired Higher-Level Functional Capacity as a Predictor of Stroke in Community-Dwelling Older Adults: The Ohasama Study.
复制标题
作为社区老年人中风预测因子的高级功能能力受损：Ohasama 研究。
DOI：
10.1161/strokeaha.115.011131
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发表时间：
2016
期刊：
影响因子：
8.3
通讯作者：
Ohkubo T.
中科院分区：
文献类型：
--
作者：
Murakami K;Tsubota-Utsugi M;Satoh M;Asayama K;Inoue R;Ishiguro A;Matsuda A;Kanno A;Yasui D;Murakami T;Metoki H;Kikuya M;Imai Y;Ohkubo T.
背景和目的功能能力是脑卒中的一个预测因子，也是脑卒中的一个后果。然而，很少有研究已经做了检查是否更高层次的功能能力以上的基本活动的日常生活是一个预测stroke.MethodsWe遵循1493日本社区居住的成年人年龄≥60岁（平均年龄，70.1岁），独立的日常生活的基本活动，没有中风的历史。使用自填问卷收集基线数据。使用东京都老年医学研究所能力指数的总分和3个分量表（日常生活工具活动、智力活动和社会角色）测量高级功能能力。调整后的风险比和95%的置信区间计算的考克斯比例风险model.ResultsDuring平均随访10.4年，191名参与者开发了第一次中风。基于东京都老年学研究所能力指数总分的高级功能能力受损与卒中显著相关（风险比，1.64; 95%置信区间，1.15-2.33）。在3个分量表中，只有智力活动与卒中显著相关（风险比，1.64; 95%置信区间，1.21-2.22）。社会角色仅在年龄≥75岁的人群中与卒中显著相关（危害比，1.78; 95%置信区间，1.07-2.98）。结论高级功能能力受损，尤其是在智力活动领域，是卒中的预测因子，即使在基线时具有独立基本日常生活活动的社区居住老年人中也是如此。监测更高水平的功能能力可能有助于发现那些在未来发生中风的风险较高的人。
Background and PurposeFunctional capacity is a predictor, as well as a consequence, of stroke. However, little research has been done to examine whether higher-level functional capacity above basic activities of daily living is a predictor of stroke.MethodsWe followed 1493 Japanese community-dwelling adults aged ≥60 years (mean age, 70.1 years) who were independent in basic activities of daily living and had no history of stroke. Baseline data were collected using a self-administered questionnaire. Higher-level functional capacity was measured using the total score and 3 subscales (instrumental activities of daily living, intellectual activity, and social role) derived from the Tokyo Metropolitan Institute of Gerontology Index of Competence. Adjusted hazard ratios and 95% confidence intervals were calculated by the Cox proportional hazards model.ResultsDuring a mean follow-up of 10.4 years, 191 participants developed a first stroke. Impaired higher-level functional capacity based on total score of the Tokyo Metropolitan Institute of Gerontology Index of Competence was significantly associated with stroke (hazard ratio, 1.64; 95% confidence interval, 1.15–2.33). Among the 3 subscales, only intellectual activity was significantly associated with stroke (hazard ratio, 1.64; 95% confidence interval, 1.21–2.22). Social role was significantly associated with stroke only among those aged ≥75 years (hazard ratio, 1.78; 95% confidence interval, 1.07–2.98).ConclusionsImpaired higher-level functional capacity, especially in the domain of intellectual activity, was a predictor of stroke, even among community-dwelling older adults with independent basic activities of daily living at baseline. Monitoring of higher-level functional capacity might be useful to detect those at higher risk of developing stroke in the future.