Association of Life-Course Neighborhood Deprivation With Frailty and Frailty Progression From Ages 70 to 82 Years in the Lothian Birth Cohort 1936.
Association of Life-Course Neighborhood Deprivation With Frailty and Frailty Progression From Ages 70 to 82 Years in the Lothian Birth Cohort 1936.
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1936年，洛锡安出生队列中，生命之路社区的贫困与脆弱和脆弱的进步从70岁到82岁。
DOI：
10.1093/aje/kwac134
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发表时间：
2022-10-20
影响因子：
5
通讯作者：
中科院分区：
文献类型：
--
作者：
社区特征一直被认为是脆弱的关键预测因素。然而，证据主要局限于横断面研究，没有长期影响的迹象。我们探索了整个生命过程中的邻里社交剥夺(NSD)是如何与苏格兰老年人的虚弱和虚弱进展相关的。参与者(n=2323)是从1936年洛锡安出生队列中挑选出来的，他们对儿童(1936-1955)、青年(1956-1975)和成年中后期(1976-2014)的NSD进行了历史测量。在70岁到82岁之间，使用脆弱指数对脆弱程度进行了5次测量。使用结构化建模方法评估混杂因素调整的生命过程模型；使用线性回归评估基线时脆弱的关联性，使用线性混合效应模型评估脆弱进展的相关性。累积是男性最合适的生命过程模型；累积的NSD越大，基线时的脆弱程度越高(b=0.017，95%可信区间：0.005，0.029)。在女性中，成年中后期敏感期是最适合的生命过程模式，在这一时期较高的NSD与更宽的脆弱轨迹相关(b=0.0.005，95%可信区间：0.0004，0.009)。据我们所知，这是第一次在老年人队列中调查NSD对脆弱的生命过程的影响。旨在解决整个生命过程中的剥夺和不平等问题的政策可能会支持健康老龄化。
Neighborhood features have been postulated to be key predictors of frailty. However, evidence is mainly limited to cross-sectional studies without indication of long-term impact. We explored how neighborhood social deprivation (NSD) across the life course is associated with frailty and frailty progression among older Scottish adults. Participants (n = 323) were persons selected from the Lothian Birth Cohort 1936 with historical measures of NSD in childhood (1936–1955), young adulthood (1956–1975), and mid- to late adulthood (1976–2014). Frailty was measured 5 times between the ages of 70 and 82 years using the Frailty Index. Confounder-adjusted life-course models were assessed using a structured modeling approach; associations were estimated for frailty at baseline using linear regression and for frailty progression using linear mixed-effects models. Accumulation was the most appropriate life-course model for males; greater accumulated NSD was associated with higher frailty at baseline (b = 0.017, 95% confidence interval: 0.005, 0.029). Among females, the mid- to late adulthood sensitive period was the best-fitting life-course model, and higher NSD in this period was associated with widening frailty trajectories (b = 0.005, 95% confidence interval: 0.0004, 0.009). To our knowledge, this is the first investigation of the life-course impact of NSD on frailty in a cohort of older adults. Policies designed to address deprivation and inequalities across the full life course may support healthy aging.
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