Health, functioning, and disability in older adults--present status and future implications.
Health, functioning, and disability in older adults--present status and future implications.
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DOI：
10.1016/s0140-6736(14)61462-8
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发表时间：
2015-02-07
期刊：
影响因子：
--
通讯作者：
Verdes E
中科院分区：
文献类型：
--
作者：
Chatterji S;Byles J;Cutler D;Seeman T;Verdes E
老龄化是一个动态的过程，由于一系列因素，老年人的健康状况随着时间的推移而变化的趋势。我们研究了过去20年来报告的老年人发病率和死亡率的趋势，以确定世界各地的老龄化模式。我们发现了一些减少发病率的证据，即，在以下情况下，健康状况恶化的时间减少：a)根据评价标准分数，研究质量良好；b)使用与残疾或损害有关的发病率衡量标准；c)研究是纵向的；或d)在美国和其他一些高收入国家进行研究。许多研究报告了相反的证据，即发病率的扩大，但使用不同的方法，这些不能直接进行比较。在研究慢性病患病率的趋势时，发病率的扩大更为常见。我们对纵向老龄化调查数据的二次分析呈现了类似的图景。然而，随着时间的推移，各国在运作上的限制模式和国家内部存在着相当大的差异，没有明显的解释。来自低收入国家的数据非常稀少，迫切需要努力收集关于世界欠发达地区老年人健康状况的信息。需要进行研究，重点是完善一套核心功能领域的衡量标准，并研究这些不断演变的模式对保健系统的影响及其经济影响。
Aging is a dynamic process with trends in health status of older adults varying over time due to a range of factors. We examined reported trends in morbidity and mortality among older adults over the past two decades in order to determine patterns of ageing across the world. We found some evidence for compression of morbidity, i.e., less amount of time spent in worse health, when: a) studies were of a good quality based on evaluation criteria scores; b) a disability- or impairment-related measure of morbidity was used; c) studies were longitudinal or; d) studies were conducted in the United States and some other high income countries. Many studies reported evidence to the contrary, i.e., for an expansion of morbidity but with different methods these are not directly comparable. Expansion of morbidity was more common when trends in chronic disease prevalence were studied. Our secondary analysis of data from longitudinal ageing surveys present a similar picture. However, there are considerable variations across countries in patterns of limitations in functioning and within countries over time with no discernible explanations. Data from low income countries is very sparse and efforts to collect information on the health of older adults in less-developed regions of the world is urgently required. Studies focussing on refining measurement with a core set of domains of functioning and studying the impacts of these evolving patterns on the health care system and their economic implications are needed.