Observation on survival of the elderly by the severity of impaired activity of daily life and causes of death

老年人日常生活活动能力受损严重程度及死亡原因的生存观察

• 批准号: 12672190
• 负责人: UEDA Kazuo
• 金额: $ 2.18万
• 依托单位: KYUSHU UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-12672190/
• 关键词: activity of daily life; quality of life; JACCDC cohort; elderly population; Barthel index; prognosis of life

Life expectancy of the elderly for the Japanese is growing year by year, and in consequence Japan runs up to the top ranking of longevity in the world. Geriatric society estimated only by life expectancy, however, is not necessarily mature, and one of factors to inhibit the completeness of fully ripe geriatric society is impaired activity of daily life (ADL) of the elderly.The Japanese Association for Cerebro-cardiovascular Disease Control (JACCDC) has studied actual figures of impaired ADL including 6,000 〜 13,000 subjects aged 65 or over extracted from 10 to 12 areas throughout Japan from 1996 to 1997. Based on the data we estimated quantitatively the severity of impaired ADL of the elderly by Barthel index in 1998. In this study we have followed up 1,492 elderly subjects (11.5 % of JACCDC cohort) with impaired ADL for three years from 1998 to 2001, and obtained data on survival aimed at elucidating an influence of impaired ADL on victim's outcome. During three years of follow-up 130 elderly died (9 %). We classified the severity of impaired ADL into three groups, namely, severe (A group, A・G), moderate (B group, B・G) and slight (C group, C・G), and compared survived rates (Kaplan-Miere) among three groups. Survival most decreased in A・G followed by order of B・G and C・G. We have corrected survived rates by the state of medical treatment and aid-assistance during the follow-up using Cox's proportional hazard model. The impaired ADL most affected survival even though these parameters were taken into account.After adjustment relative risk of dead for A・G and B・G to C・G was 2.6 and 1.9 in each (p<0.01).In conclusion, the severe impaired ADL was, the poorer prognosis of life of the elderly was observed without any relation to medical treatment and aid-care.Since cerebral stroke mostly gave an influence on the severity of impaired ADL for the elderly, preventive strategy of cerebral stroke seems to be most effective on making healthy geriatric society.

日本老年人的预期寿命逐年增长，因此日本在世界长寿方面名列前茅。然而，仅用寿命来估计的老年社会并不一定是成熟的，妨碍老年社会完全成熟的因素之一是老年人日常生活活动能力（ADL）受损。日本心脑血管疾病控制协会（JACCDC）研究了ADL受损的实际数字，包括6，000人13岁，1996年至1997年，从日本10至12个地区抽取了65岁或以上的000名受试者。在此基础上，我们于1998年采用Barthel指数对老年人日常生活活动能力受损程度进行了定量评估。本研究从1998年至2001年对1,492名ADL受损的老年受试者（占JACCDC队列的11.5%）进行了为期3年的随访，并获得了旨在阐明ADL受损对受害者结局的影响的生存数据。在三年的随访中，130名老年人死亡（9%）。将ADL受损程度分为重度（A组，A·G）、中度（B组，B·G）和轻度（C组，C·G）3组，比较3组生存率（Kaplan-Miere法）。A·G组存活率下降最多，其次为B·G组和C·G组。我们使用考克斯比例风险模型，根据随访期间的医疗和援助状况校正了生存率。校正后A·G和B·G与C·G的死亡相对危险度分别为2.6和1.9（p<0.01）。综上所述，老年人的生活预后较差，与医疗救助无关，由于脑卒中主要影响老年人ADL受损的严重程度，因此脑卒中的预防策略似乎是建立健康老年社会的最有效方法。

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