Sauvaget C, Tsuji I, Aonuma T, Hisamichi S
Tohoku University Graduate School of Medicine, Department of Social Medicine, Sendai, Japan.
J Am Geriatr Soc. 1999 Nov;47(11):1326-31. doi: 10.1111/j.1532-5415.1999.tb07433.x.
OBJECTIVES: To estimate disability-free life expectancy according to three functional levels. DESIGN: A 2-year prospective study of older residents in a rural Japanese community. The functional ability of each individual was determined with self-completed questionnaires at baseline (1994) and at follow-up (1996). SETTING AND PARTICIPANTS: All residents of Wakuya Town, Japan, who were aged 65 years or older at the start of the study in 1994 (n = 3590). MEASUREMENTS: Single-year increment-decrement life tables were constructed from mortality rates and incidence of disability rates. Independent life expectancies in three functional areas: basic activities of daily living (ADL), instrumental activities of daily living (IADL), and mobility, were estimated for each sex and each year of age. RESULTS: The incidence and prevalence of disability were similar in men and women. For both sexes, independent life in IADL was shorter than independent life in ADL and mobility. The development and progression of disability were different between sexes: men experienced disability at a younger age and at a faster rate than women. CONCLUSIONS: The slow progress of disability, with a longer duration in a disabled state among women, induces a heavy burden on health and welfare resources. Interventions to delay the onset of disability in women should reduce the economic burden to society as well as improve the quality of life. Prospective studies to look at the process of disablement, based on direct observation, are needed to confirm the gender differences.
目的:根据三种功能水平估计无残疾预期寿命。 设计:对日本农村社区老年居民进行的为期2年的前瞻性研究。在基线(1994年)和随访(1996年)时通过自我填写问卷确定每个人的功能能力。 背景与参与者:日本若叶町所有居民,在1994年研究开始时年龄在65岁及以上(n = 3590)。 测量:根据死亡率和残疾发生率构建单年增减生命表。估计了每个性别和每个年龄组在三个功能领域的独立预期寿命:日常生活基本活动(ADL)、日常生活工具性活动(IADL)和活动能力。 结果:男性和女性的残疾发生率和患病率相似。对于两性而言,IADL方面的独立生活时间短于ADL和活动能力方面的独立生活时间。两性之间残疾的发展和进展有所不同:男性比女性在更年轻的时候经历残疾,且速度更快。 结论:残疾进展缓慢,女性处于残疾状态的持续时间更长,给健康和福利资源带来沉重负担。延缓女性残疾发作的干预措施应减轻社会经济负担并提高生活质量。需要基于直接观察的前瞻性研究来观察致残过程,以证实性别差异。
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