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

该项目旨在通过纵向研究阐明社区老年人口的致残过程，并评估通过社区干预改善老年人营养和体力活动的抗衰老计划。主要研究结果有以下三点。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，检验了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。影响BADL和IADL的常见因素有年龄、职业、睡眠时间、自评健康、智力活动和社会角色、步行能力、咀嚼能力、住院史和血清β_2-微球蛋白水平。第二，我们考察了不同类型的家庭边界(类型1和类型2)对功能变化的影响以及每种类型的家庭边界…的发生的预测因子通过对1,544名居住在社区的老年人进行为期两年的前瞻性数据，得出了更多的裸体。调整后的2型家庭边界相对危险度为2.30(95%CI，1.14~4.61)，2.85(1.20~6.82)，1.63(0.87~3.06)，3.05(1.06~8.78)。预测1型归属感的因素主要是生理和心理因素(行走能力、认知等)，而2型归属感的预测因素主要是心理社会因素(社会网络、认知等)。第三，采用抗衰老计划进行的为期一年的社区干预使1400名社区老年人的营养状况和体力活动得到改善；干预期和强化干预组的步行速度、血清白蛋白水平和抑郁情绪的年龄相关性下降得到改善。综上所述，我们得出的结论是，晚年生活中的功能状态受到与年龄相关的身心功能下降以及家庭约束状态的显著影响；然而，即使在晚年生活中，通过采取适当的生活方式调整计划，这些变化也可以得到改善。较少

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