Determinants of ADL and IADL disability in older adults in southeastern Poland
Determinants of ADL and IADL disability in older adults in southeastern Poland
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DOI：
10.1186/s12877-019-1319-4
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发表时间：
2019-10-31
期刊：
影响因子：
4.1
通讯作者：
Sozanski, Bernard
中科院分区：
文献类型：
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作者：
Cwirlej-Sozanska, Agnieszka;Wisniowska-Szurlej, Agnieszka;Sozanski, Bernard
随着寿命的延长，老年人的数量增加，60岁以上人群的残疾患病率也在增加。本研究的目的是评估生活在波兰东南部的60岁及以上人群中ADL和IADL残疾的患病率，并分析其决定因素。方法这项横断面研究是在一个随机选择的，有代表性的人口年龄在60岁及以上的人生活在东南部波兰。使用基本日常生活活动和工具性日常生活活动中的Katz独立指数来评估残疾。采用Logistic回归模型分析影响ADL和IADL的相关因素。对于上述模型中包含的变量，还检查了其对ADL或IADL限制发生的比值比增加的聚集影响。结果研究结果显示，35.75%的参与者报告至少有一个IADL问题。17.13%的参与者报告了至少一个ADL问题。影响残疾发生率的最重要的可改变因素是参与者环境中存在障碍、与亲属关系不佳、缺乏社会接触、多重恐惧症和疼痛。随着成对分析因素的存在，发现残疾的比值比成倍增加。至少一个ADL限制的最高比值比观察参与者的环境中的障碍与多morphine（OR 74.07）的组合。关于IADL功能障碍，VAS评分≥ 3分的疼痛与年龄较大（OR 19.47）的比值比最高。结论：本研究显示生活在波兰东南部的老年人中ADL和IADL残疾的患病率较高。它还表明了可改变的因素对残疾发生的影响程度，以及残疾风险随着成对因素的存在而增加的程度，特别是那些包括参与者环境中的环境障碍的因素。
Background The extension of the life span has led to an increase in the number of older people and an increase in the prevalence of disability in people over 60 years of age. The aim of this study was to assess the prevalence of ADL and IADL disability and to analyze its determinants among people aged 60 and older living in southeastern Poland. Methods This cross-sectional study was carried out among a randomly selected, representative population of people aged 60 and older living in southeastern Poland. Disability was assessed using the Katz Index of Independence in Basic Activities of Daily Living and Instrumental Activities of Daily Living. Logistic regression models were used to identify the factors related to ADLs and IADLs. For the variables that were included in the above models, their clustered influence on the increase in the odds ratio for the occurrence of an ADL or IADL limitation was also examined. Results The research results show that 35.75% of the participants reported at least one problem with IADLs. At least one problem with ADLs was reported by 17.13% of the participants. The most significant modifiable factors influencing the occurrence of disability were the presence of barriers in the participant's environment, poor relations with relatives, a lack of social contacts, multimorbidity and pain. A multiple increase in the odds ratio of disability was found with the presence of pairs of analyzed factors. The highest odds ratio of at least one ADL limitation was observed for the combination of barriers in the participant's environment with multimorbidity (OR 74.07). With regard to IADL disability, the highest odds ratio was observed for the combination of pain on the VAS scale >= 3 points with older age (OR 19.47). Conclusions The study showed a high prevalence of ADL and IADL disability in older people living in southeastern Poland. It also indicated the extent to which modifiable factors influenced the occurrence of disability and the extent to which the risk of disability increased with the presence of pairs of factors, especially those that included environmental barriers in the participant's environment.