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来阐明社区老年人的残疾过程，并通过社区干预来评估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名最初没有残疾的老年人的6年前瞻性数据检查了BADL和IADL残疾的预测因素。BADL残疾的预测因素包括医疗和身体因素，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的常见预测因子为年龄、职业、睡眠时间、自评健康、智力活动和社会角色、健康（如行走能力、咀嚼能力）、住院史和血清β_2-微球蛋白水平。其次，我们利用1,544名社区生活老年人的2年前瞻性数据，研究了不同类型（1型和2型）居家生活对功能变化的影响，以及每种类型居家生活的发病预测因素。发生活动能力丧失的2型居家的调整相对危险度为2.30 (95% CI,1.14-4.61)， IADL残疾的调整相对危险度为2.85 (1.20-6.82)，ADL残疾的调整相对危险度为1.63(0.87-3.06)，认知障碍的调整相对危险度为3.05（1.06-8.78）。1型回家发生的预测因子主要为生理和心理因素（行走能力、认知能力等），2型回家发生的预测因子主要为心理社会因素（社会网络、认知能力等）。第三，使用抗衰老项目进行为期一年的社区干预，改善了1400名社区老年人的营养状况和身体活动；干预期和强化干预组患者行走速度、血清白蛋白水平和抑郁情绪的年龄相关性下降均有改善。综上所述，我们得出的结论是，年龄相关的身心功能下降和居家状态显著影响晚年的功能状态；然而，即使在以后的生活中，通过采取适当的生活方式改变计划，这些变化也可以得到改善。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