Stability and Change in Activities of Daily Living Among Older Mexican Americans
Stability and Change in Activities of Daily Living Among Older Mexican Americans
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DOI：
10.1093/gerona/glv172
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发表时间：
2016-06-01
影响因子：
5.1
通讯作者：
Ottenbacher, Kenneth J.
中科院分区：
文献类型：
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作者：
Howrey, Bret T.;Al Snih, Soham;Ottenbacher, Kenneth J.
对老年人日常生活活动（ADL）的纵向研究已经确定了许多与能力下降相关的因素。基于人口平均值的分析可能不会观察到ADL轨迹不同的不同亚组。我们使用潜在类模型来识别来自西班牙裔老年人流行病学研究人群样本中的轨迹亚组，一项基于人口的研究，对来自西南部五个州的65岁及以上的非制度化墨西哥裔美国人进行了研究。确定了ADL限制的三种不同轨迹，并将其表征为稳定的、延迟的和快速的ADL增加。与稳定组相比，性别（女性）、糖尿病和关节炎与延迟组和快速组成员资格的几率增加相关。在稳定组（β = 1.11，p <0.001）、延迟组（β = 0.52，p <0.001）和快速组（β = 0.12，p <0.05）中，卒中对ADL限制的影响程度不同。稳定组中髋部骨折与限制增加相关（β = 1.27，p <0.001），而快速组中则无此相关性。在所有组中，参加教堂活动与较少的限制相关，与快速组相比，稳定组的影响更大（β =-0.87，p <0.001）。墨西哥裔美国老年人ADL残疾随时间的变化存在实质性异质性。维持功能的尝试可能受益于减少与残疾相关的合并症和急性健康事件。
Longitudinal studies of activities of daily living (ADL) in older adults have identified numerous factors associated with declining ability. Analyses based on population averages may not observe distinct subgroups whose ADL trajectories differ.We used latent class models to identify subgroups of trajectories in a sample from the Hispanic Established Populations for Epidemiologic Study of the Elderly, a population-based study of noninstitutionalized Mexican Americans aged 65 and older from five Southwestern states (n = 2584).Three distinct trajectories of ADL limitations were identified and characterized as stable, delayed, and rapid ADL increase. Sex (female), diabetes, and arthritis were associated with increased odds of membership in the delayed and rapid groups compared with the stable group. Stroke had a differential magnitude of effect on ADL limitations across the stable (beta = 1.11, p < .001), delayed (beta = 0.52, p < .001), and rapid groups (beta = 0.12, p < .05). Hip fracture was associated with increased limitations in the stable group (beta = 1.27, p < .001) but not in the rapid group. Church attendance was associated with fewer limitations in all groups with a larger effect in the stable group (beta = -0.87, p < .001) compared with the rapid group (beta = -0.10, p < .05).Substantial heterogeneity exists in changes in ADL disability over time among older Mexican Americans. Attempts at maintaining function may benefit from targeting reductions in comorbidities and acute health events associated with disability.