Freedman V A, Martin L G
Polisher Research Institute, Philadelphia Geriatric Center, Jenkintown, PA 19046-7128, USA.
Am J Public Health. 2000 Nov;90(11):1755-60. doi: 10.2105/ajph.90.11.1755.
This study explored the role of various chronic conditions in explaining recent improvements in functioning among older Americans.
We used the Supplements on Aging to the 1984 and 1994 National Health Interview Surveys to examine changes among Americans 70 years and older in reports of chronic conditions and functional limitations. We decomposed functioning changes into condition-related components, controlling for demographic shifts.
The percentage of older Americans with upper- and lower-body limitations declined from 5.1% and 34.2%, respectively, in 1984 to 4.3% and 28.5% in 1995, and the average number of lower body limitations decreased. During the same period, reports of 8 of 9 chronic conditions increased, but many of these conditions had less debilitating effects on functioning. Reductions in the debilitating effects of various chronic conditions--particularly arthritis--are important in explaining declines in limitations experienced by older Americans.
Earlier diagnosis and improved treatment and management of chronic conditions, rather than prevention, may be important contributing factors to improvements in upper- and lower-body functioning among older Americans.
本研究探讨了各种慢性疾病在解释美国老年人近期功能改善方面所起的作用。
我们利用1984年和1994年全国健康访谈调查的老龄补充调查，来研究70岁及以上美国人在慢性病报告和功能受限方面的变化。我们将功能变化分解为与疾病相关的组成部分，并控制人口结构变化的影响。
1984年，有上肢和下肢功能受限的美国老年人比例分别为5.1%和34.2%，到1995年分别降至4.3%和28.5%，且下肢功能受限的平均数量有所减少。在同一时期，9种慢性病中有8种的报告患病率有所上升，但其中许多疾病对功能的损害较小。各种慢性病（尤其是关节炎）致残作用的减轻，对于解释美国老年人功能受限情况的减少很重要。
慢性病的早期诊断以及治疗和管理的改善，而非预防，可能是美国老年人上肢和下肢功能改善的重要促成因素。
