Clarifying the disablement process in later life and evaluation of a community-based intervention program for retarding aging process

本项目旨在通过纵向研究阐明社区老年人口的失能过程，并评估通过社区干预改善老年人营养和身体活动的抗衰老计划。主要结果有以下三点。首先，我们使用601名最初非残疾老年人的6年前瞻性数据，研究了BADL和IADL残疾的预测因素。BADL残疾的预测因素包括医学和身体因素，而IADL残疾的预测因素包括心理社会因素和身体因素。BADL和IADL的共同预测因素是年龄、职业、睡眠时间、自测健康、智力活动和社会角色、身体素质（如步行能力、咀嚼能力）、住院史和血清β_2-微球蛋白水平。其次，我们研究了不同类型（1型和2型）的homeboundness对功能变化的影响，以及每种类型homeboundness发生的预测因素。 关于我们 使用1，544名社区老年人的2年前瞻性数据。调整后的2型居家障碍的相对风险为：行动能力丧失2.30（95%CI，1.14 -4.61），IADL残疾2.85（1.20-6.82），ADL残疾1.63（0.87-3.06），认知障碍3.05（1.06-8.78）。1型居家癖的预测因素主要是生理和心理因素（行走能力、认知能力等），而第二类宅家的影响因素主要是社会心理因素（社会网络、认知等）。第三，为期一年的以社区为基础的干预，使用抗衰老计划产生了改善的营养状况和身体活动的1,400名社区生活的老年人;与年龄相关的步行速度，血清白蛋白水平和抑郁情绪的下降在干预期间和强化干预组得到改善。总之，我们的结论是，功能状态在以后的生活中受到显着影响的年龄相关的身体和精神功能的下降，以及居家状态，但是，这些变化可以得到改善，即使在以后的生活中，通过采用适当的程序，生活方式的修改。少

This project aimed at clarifying the disablement process in community older population by longitudinal studies and evaluating the anti-aging program of improving nutrition and physical activity among older people by a community-based intervention. Main results were the following three points. First, we examined the predictors for BADL and IADL disability using 6-year prospective data on 601 initially non-disabled older people. Predictors for BADL disability included medical and physical factors, while those for IADL disability included psychosocial factors as well as physical factors. Common predictors both for BADL and IADL were age, occupation, sleep hours, self-rated health, Intellectual Activity and Social Roles, fitness such as walking ability, chewing ability, history of hospital admission, and serum β_2-microglobulin level. Second, we examined the effects of different types (type 1 and 2) of homeboundness on functional changes and predictors for the onset of each types of homebo … More undness using 2-year prospective data on 1,544 community-living older people. Adjusted relative risk of type 2 homeboundness was 2.30 (95% CI,1.14-4.61) for developing mobility loss, 2.85 (1.20-6.82) for IADL disability, 1.63 (0.87-3.06) for ADL disability, and 3.05 (1.06-8.78) for cognitive impairment. Predictors for the onset of type 1 homeboundness were mainly physical and psychological factors (walking ability, cognition, etc.), while those for type 2 homeboundness were mainly psychosocial factors (social network, cognition, etc.). Third, one-year community-based intervention using the anti-aging program yielded an improvement of nutritional state and physical activity among 1,400 community-living older people ; age-associated decrement in walking speed, serum albumin level and depressive mood were improved in the intervention period and intensive intervention group. All together, we conclude that functional state in later life were significantly affected by age-associated decline in physical and mental function as well as homebound state ; however, these changes could be improved even in later life by adoption of an appropriate program for life-style modification. Less