Sarkisian C A, Liu H, Ensrud K E, Stone K L, Mangione C M
Department of Medicine, UCLA School of Medicine, Los Angeles, California 90095-1687, USA.
J Am Geriatr Soc. 2001 Feb;49(2):134-41. doi: 10.1046/j.1532-5415.2001.49033.x.
To describe women who attribute new disability to old age and to identify demographic, medical, behavioral, and psychosocial characteristics that correlate with attributing new disability to old age.
Prospective cohort study with 4-year follow-up.
Four geographic regions of the United States.
9704 women aged > or = 67 years participating in the Study of Osteoporotic Fractures. Of these, 657 who reported no disability at baseline but at follow-up reported difficulty carrying out 1 or more of 13 functional activities were eligible for our analysis.
All women reporting difficulty in any functional activity at follow-up were asked "What is the main condition that causes you to have difficulty or prevents you from (doing the activity)?" and were shown a card listing 14 medical conditions as well as the option "old age," from which they could choose only one response. Women attributing difficulty or inability in 1 or more functional activities to old age were classified as attributing new disability to old age. We examined the relationship between attributing new disability to old age and the following characteristics measured at baseline: age, level of education, medical comorbidity, cognitive function, body mass index (BMI), gait speed, grip strength, visual acuity, physical activity level, smoking status, social network level, and depressed mood.
Overall, 13.5% of women attributed new disability to old age. Age was a strong independent correlate of attributing new disability to old age: compared with women age 67 to 69, the odds of attributing new disability to old age for women age 70 to 79 was 3.6 times as large (95% confidence interval [CI] = 1.6-8.3), and for women age 80 or over was 5.5 times as large (95% CI = 2.1-14.7). The only other characteristic that remained an independent correlate of attributing new disability to old age was grip strength; for each decile decrease in grip strength, a woman's odds of attributing new disability to old age increased by 9% (odds ratio [OR] = 1.09, 95% CI = 1.01-1.19).
Despite great advances in geriatric medicine, old age is still perceived as a causal agent in functional decline, especially among our oldest patients. Further study is needed to determine whether, how often, and under what circumstances older adults who attribute new disability to old age have medical conditions amenable to interventions that could preserve their functioning and improve their quality of life.
描述将新出现的残疾归因于年老的女性，并确定与将新出现的残疾归因于年老相关的人口统计学、医学、行为和心理社会特征。
为期4年随访的前瞻性队列研究。
美国的四个地理区域。
9704名年龄≥67岁的女性参与骨质疏松性骨折研究。其中，657名在基线时报告无残疾但在随访时报告难以进行13项功能活动中的1项或多项的女性符合我们的分析条件。
所有在随访时报告任何功能活动有困难的女性都被问到“导致你有困难或无法（进行该活动）的主要状况是什么？”，并被展示一张列出14种医学状况以及“年老”选项的卡片，她们只能选择一个答案。将1项或多项功能活动的困难或无能力归因于年老的女性被归类为将新出现的残疾归因于年老。我们研究了将新出现的残疾归因于年老与基线时测量的以下特征之间的关系：年龄、教育程度、合并症、认知功能、体重指数（BMI）、步速、握力、视力、身体活动水平、吸烟状况、社交网络水平和抑郁情绪。
总体而言，13.5%的女性将新出现的残疾归因于年老。年龄是将新出现的残疾归因于年老的一个强有力的独立相关因素：与67至69岁的女性相比，70至79岁女性将新出现的残疾归因于年老的几率是其3.6倍（95%置信区间[CI]=1.6 - 8.3），80岁及以上女性是其5.5倍（95%CI = 2.1 - 14.7）。唯一仍然是将新出现的残疾归因于年老的独立相关因素的其他特征是握力；握力每降低一个十分位数，女性将新出现的残疾归因于年老的几率增加9%（优势比[OR]=1.09，95%CI = 1.01 - 1.19）。
尽管老年医学取得了巨大进展，但年老仍被视为功能衰退的一个病因，尤其是在我们最年长的患者中。需要进一步研究以确定将新出现的残疾归因于年老的老年人是否、多频繁以及在何种情况下存在适合干预的医学状况，这些干预可以维持他们的功能并改善他们的生活质量。
