Comparing the loss of functional independence of older adults in the US and China
Comparing the loss of functional independence of older adults in the US and China
复制标题
DOI：
10.1016/j.archger.2017.10.020
复制
发表时间：
2018-01-01
影响因子：
4
通讯作者：
Feng, Jun
中科院分区：
文献类型：
--
作者：
Fong, Joelle H.;Feng, Jun
工作背景：已知老年人的功能丧失遵循一个层次序列，但很少有人知道这种序列是否在社会文化背景下有所不同。本研究的目的是构建日常生活活动（ADL）量表在美国和中国的老年人，以比较他们的功能损失sequences.Methods：我们使用的数据从资产和健康动态的最老的老人（n = 1607）和中国纵向健康长寿调查（n = 5570）1998-2008年。使用Rasch测量模型在量表内校准ADL项目。Rasch评分在调查波中取平均值，以确定每个研究人群的ADL损失序列。我们还评估规模的稳定性超过measurementperiods.Results：因子分析证实，在每个研究人群中的ADL项目可以结合起来有意义的，形成一个层次序列。内部一致性评估的克朗巴赫的α是高的（0.81至0.95）。我们发现，洗澡是美国老年人和中国老年人都有困难的第一项活动，而吃饭是最后一项活动。然而，在排队（在中国样本中排名更具挑战性）和穿衣（在美国样本中排名更具挑战性）的排序上存在差异。项目排序是稳定的，随着时间的推移。结论：结果突出的相对重要性，洗澡的功能丧失序列的老年人，无论社会文化背景。卫生干预措施需要解决浴室环境的缺陷，特别是在中国这样的发展中国家。
Background: Functional loss among older adults is known to follow a hierarchical sequence, but little is known about whether such sequences differ across socio-cultural contexts. The aim of this study is to construct activities of daily livings (ADL) scales for oldest-old adults in the United States and China so as to compare their functional loss sequences.Methods: We use data from the Asset and Health Dynamics of the Oldest Old (n = 1607) and Chinese Longitudinal Healthy Longevity Survey (n = 5570) for years 1998-2008. ADL items are calibrated within a scale using the Rasch measurement model. Rasch scores are averaged across survey waves to identify the ADL loss sequence for each study population. We also assess scale stability over measurement periods.Results: Factor analyses confirm that the ADL items in each study population can be combined meaningfully to form a hierarchical sequence. Internal consistency assessed by Cronbach's alpha is high (0.81 to 0.95). We find that bathing is the first activity that both older Americans and Chinese have difficulty with, while eating is the last activity. There are, however, differences in the rank order for toileting (ranked more challenging in the Chinese sample) and dressing (ranked more challenging in the U.S. sample). Item orderings are stable over time.Conclusions: The results highlight the relative importance of bathing in the functional loss sequence for older adults, regardless of socio-cultural context. Health interventions are needed to address deficits in the bathroom environment, especially in developing countries like China.