Prospective study on the relation between living arrangement and change in functional health status of elderly women.
Prospective study on the relation between living arrangement and change in functional health status of elderly women.
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DOI：
10.1093/oxfordjournals.aje.a009459
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发表时间：
1998-02
影响因子：
5
通讯作者：
A. Sarwari;L. Fredman;P. Langenberg;J. Magaziner
中科院分区：
文献类型：
--
作者：
A. Sarwari;L. Fredman;P. Langenberg;J. Magaziner
有限的前瞻性数据存在如何生活安排与功能健康的变化。这项研究评估了独居的老年妇女与与其他人一起生活的妇女相比是否不太可能出现功能衰退。从1984年到1986年，每年对来自马里兰州巴尔的摩的619名社区居住的白色妇女进行调查，基线年龄为65-99岁。功能性健康被测量为七种身体和七种工具性日常生活活动（工具性ADL）的限制之和。在2年内，共有148名女性出现功能下降，主要表现为工具性ADL恶化。生活安排与工具性日常生活活动能力变化之间的关系取决于身体损伤的程度。在无严重损害的女性中，与与配偶（OR = 0.60，95%置信区间（CI）0.45-0.92）或非配偶其他人（OR = 0.62，95% CI 0.45-0.96）生活在一起的人相比，独居者的工具性ADL恶化明显较少。然而，对于严重损伤的女性，独居者的工具性ADL下降更大，特别是与非配偶其他人相比（OR = 5.13，95%CI 1.23-21.28）。这些结果表明，除非身体严重受损，独立生活的妇女与其他生活安排的同龄人相比，功能健康状况的恶化程度较小。
Limited prospective data exist on how living arrangements are associated with change in functional health. This study evaluated whether elderly women living alone were less likely to experience functional decline when compared with women who lived with others. A total of 619 community-dwelling, white women from Baltimore, Maryland, aged 65-99 years at baseline were questioned annually from 1984 to 1986. Functional health was measured as the sum of limitations in seven physical and seven instrumental activities of daily living (Instrumental ADL). A total of 148 women experienced functional decline over the 2 years, primarily as a deterioration in Instrumental ADL. The association between living arrangement and change in Instrumental ADL depended on the level of physical impairment. Among women without severe impairment, Instrumental ADL deterioration was significantly less for those living alone compared with those living with spouses (odds ratio (OR) = 0.60, 95% confidence interval (CI) 0.45-0.92) or nonspouse others (OR = 0.62, 95% CI 0.45-0.96). For women with severe impairment, however, those living alone had a greater decline in Instrumental ADL, especially when compared with those living with nonspouse others (OR = 5.13, 95% CI 1.23-21.28). These results suggest that, unless severely physically impaired, women living independently have less deterioration in functional health when compared with peers in alternate living arrangements.