Leveille S G, Penninx B W, Melzer D, Izmirlian G, Guralnik J M
Epidemiology, Demography, and Biometry Program, National Institute on Aging, Bethesda, Maryland, USA.
J Gerontol B Psychol Sci Soc Sci. 2000 Jan;55(1):S41-50. doi: 10.1093/geronb/55.1.s41.
This study examined sex differences in the prevalence of mobility disability in older adults according to the influences of three components of prevalence: disability incidence, recovery from disability, and mortality.
Participants in a population-based study of older adults from three communities in the United States (N = 10,263) were studied for up to 7 years. Life table methods were used to estimate the influence of each of the three components of disability prevalence in women and men. Sex differences in probabilities for transition states were measured by relative risks derived from a single model using a Markov chain approach.
The proportion of disabled women increased from 22% of women aged 70 years to 81% of those aged 90 years. In men, comparable figures were 15% and 57%. Incidence had the greatest impact on the sex differences in disability prevalence until age 90 and older when recovery rates had a greater impact on differences in prevalence. Mortality differences in men and women had only a modest impact on sex differences in disability prevalence. These findings initially seemed to contradict striking sex differences observed in the relative risks for mortality in men compared with women. Subsequent graphical analyses showed that incidence rather than recovery or mortality largely accounted for sex differences in disability prevalence in old age.
Disability incidence, recovery from disability, and mortality dynamically influence the sex differences in the prevalence of mobility disability. However, incidence has the greatest impact overall on the higher prevalence of disability in women compared with men.
本研究根据残疾流行率的三个组成部分（残疾发生率、残疾恢复情况和死亡率）的影响，探讨老年人行动不便流行率的性别差异。
对美国三个社区的一项基于人群的老年人研究中的参与者（N = 10263）进行了长达7年的研究。采用生命表方法来估计残疾流行率的三个组成部分对男性和女性的影响。通过使用马尔可夫链方法从单一模型得出的相对风险来衡量过渡状态概率的性别差异。
残疾女性的比例从70岁女性的22%增加到90岁女性的81%。在男性中，相应的数字分别为15%和57%。在90岁及以上之前，发病率对残疾流行率的性别差异影响最大，而在90岁及以上时，恢复率对流行率差异的影响更大。男性和女性的死亡率差异对残疾流行率的性别差异影响较小。这些发现最初似乎与观察到的男性与女性死亡率相对风险中的显著性别差异相矛盾。随后的图形分析表明，发病率而非恢复率或死亡率在很大程度上解释了老年残疾流行率的性别差异。
残疾发生率、残疾恢复情况和死亡率动态影响行动不便流行率的性别差异。然而，总体而言，发病率对女性比男性更高的残疾流行率影响最大。
