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老年人的身体活动、功能受限与残疾

Physical activity, functional limitations, and disability in older adults.

作者信息

Miller M E, Rejeski W J, Reboussin B A, Ten Have T R, Ettinger W H

机构信息

Department of Public Health Sciences, Wake Forest University, Winston-Salem, North Carolina 27157, USA.

出版信息

J Am Geriatr Soc. 2000 Oct;48(10):1264-72. doi: 10.1111/j.1532-5415.2000.tb02600.x.

Abstract

OBJECTIVES

To explore initially how low levels of physical activity influence lower body functional limitations in participants of the Longitudinal Study of Aging. Changes in functional limitations are used subsequently to predict transitions in the activities of daily living/instrumental activities of daily living (ADL/IADL) disability, thus investigating a potential pathway for how physical activity may delay the onset of ADL/IADL disability and, thus, prolong independent living.

DESIGN

Analysis of a complex sample survey of US civilian, noninstitutionalized population aged 70 years and older in 1984, with repeated interviews in 1986, 1988, and 1990.

SETTING AND PARTICIPANTS

Analyses concentrated on 5151 men and women targeted for interview at all four LSOA interviews.

MEASUREMENTS

Characteristics used in analyses: gender, age, level of physical activity, comorbid conditions including the presence of hypertension, diabetes, arthritis, and atherosclerotic heart disease, levels of functional limitations, and ADL/IADL disability.

RESULTS

Transitional models provide evidence that older adults who have varying levels of disability and who report at least a minimal level of physical activity experience a slower progression in functional limitations (OR = .45, P < .001 for severe vs less severe limitations). This low level of physical activity, through its influence on changes in functional limitations, is shown to slow the progression of ADL/IADL disability.

CONCLUSIONS

Results from analyses provide supporting evidence that functional limitations can mediate the effect that physical activity has on ADL/IADL disability. These results contribute further to the increasing data that seem to suggest that physical activity can reduce the progression of disability in older adults.

摘要

目的

初步探讨低水平身体活动如何影响老年纵向研究参与者的下肢功能受限情况。随后,利用功能受限的变化来预测日常生活活动/工具性日常生活活动(ADL/IADL)残疾的转变,从而研究身体活动可能延缓ADL/IADL残疾发作并延长独立生活时间的潜在途径。

设计

对1984年美国70岁及以上非机构化平民人口进行的复杂样本调查分析,并于1986年、1988年和1990年进行重复访谈。

地点和参与者

分析集中在所有四次老年纵向研究访谈中被选定进行访谈的5151名男性和女性。

测量

分析中使用的特征:性别、年龄、身体活动水平、共病情况,包括高血压、糖尿病、关节炎和动脉粥样硬化性心脏病的存在、功能受限水平以及ADL/IADL残疾情况。

结果

过渡模型提供了证据,表明残疾程度不同且报告至少有最低水平身体活动的老年人,其功能受限的进展较慢(重度与轻度受限相比,OR = 0.45,P < 0.001)。这种低水平的身体活动通过其对功能受限变化的影响,被证明减缓了ADL/IADL残疾的进展。

结论

分析结果提供了支持性证据,表明功能受限可介导身体活动对ADL/IADL残疾的影响。这些结果进一步补充了越来越多的数据,这些数据似乎表明身体活动可以减少老年人残疾的进展。

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