A longitudinal study on relations of lifestyle characteristics to functional health and long-term care use in elderly persons

基于对高知县大月镇65岁及以上社区居民的四年纵向研究，我们检查了生活方式特征与功能健康损害和老年人长期护理使用的关系。在1017名基线时既没有日常生活体力活动（ADL）障碍，也没有体力表现障碍、睡眠时间不合适、早晨缺乏摆脱困倦的意识、没有定期进行体力活动、没有接受工具支持(即：没有一个人可以让受试者帮忙处理日常事务，也没有一个人可以让受试者在紧急情况下打电话)与身体机能障碍有关，而在随访时间点没有伴随ADL障碍。如果ADL功能障碍之前存在身体功能障碍，良好的睡眠习惯、增加身体活动、接受辅助支持可以通过改变身体功能障碍的风险来预防ADL功能障碍的发生。研究人员对1,681名在基线时无日常生活能力障碍的人进行了与长期护理使用相关的特征检查，并在随访时间点确定了他们在家中或公共长期护理保险覆盖的机构中使用长期护理服务。缺乏体育活动和缺乏近亲和友好邻居的可用性与长期护理使用有关。增加身体活动和获得家庭成员以外的网络资源有助于降低长期护理使用的风险。

Based on a four-year longitudinal study for community-dwelling persons aged 65 and older in Otsuki town, Kochi prefecture, we examined relations of lifestyle characteristics to impairment of functional health and the use of long-term care amont older persons. In1,017 persons who had neither physical activities of daily living (ADL) impairment nor physical performance impairment at baseline, having inappropriate hours of sleep, lack of sense of getting rid of sleepiness in the morning, not taking regular physical activity and not receiving instrumental support (i.e., not having a person whom the subject can ask to do favors for routine affairs and not having a person who the subject can call at emergency) were associated with physical performance impairment not accompanying ADL impairment at the follow-up time point. If ADL impairment were preceded by physical performance impairment, having favorable sleeping habit, increasing physical activity, and receiving instrumental support could prevent occurrence of ADL impairment through altering the risk of physical performance impairment. Characteristics associated with the long-term care use were examined for 1,681 persons who had not ADL impairment at baseline and whose use of long-term care services at home or at institutions covered by the public long-term care insurance were ascertained at the follow-up time point. Lack of physical activity and lack of availability of close relatives and friendly neighbors were associated with the long-term care use. Increasing physical activity and obtaining network resources other than one's family members contribute to decreasing the risk for long-term care use.