Wentzel C, Rose H, Rockwood K
Division of Geriatric Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Int Psychogeriatr. 2001;13 Supp 1:215-21. doi: 10.1017/s1041610202008153.
A paucity of information exists to characterize the relationship between the health status of elderly people and their physical environment. The Canadian Study of Health and Aging (CSHA) is a multicenter study of the distribution of dementia among community-dwelling and institutionalized Canadians aged 65 years and older. The study also provides the opportunity to examine issues such as the physical environment which may be related to the health of elderly people. Six items were used to assess the cleanliness, neatness, and maintenance of the inside and outside of the homes of 8,134 community-dwelling individuals. Data were also obtained to evaluate cognition, physical health, and functional capacity. Five years after the original survey, information pertaining to subsequent institutionalization and/or mortality was obtained. A significant relationship was found between classification of physical environment and the outcomes of institutionalization and mortality. The likelihood of both adverse outcomes was notably higher for individuals living in a "less than ideally maintained environment" compared to an "ideally maintained environment." Limitations of the six items used to assess the physical environment and ways in which to improve the sensitivity of the items, consequently avoiding measurement bias, are discussed.
目前，关于老年人健康状况与其物理环境之间关系的信息匮乏。加拿大健康与老龄化研究（CSHA）是一项多中心研究，旨在调查65岁及以上居住在社区和机构中的加拿大人患痴呆症的分布情况。该研究还提供了一个机会，来研究诸如可能与老年人健康相关的物理环境等问题。研究使用了六个项目来评估8134名居住在社区的个体家庭内外的清洁程度、整洁程度和维护情况。同时还获取了评估认知、身体健康和功能能力的数据。在最初调查五年后，获得了与随后的机构化和/或死亡率相关的信息。研究发现，物理环境分类与机构化和死亡率结果之间存在显著关系。与“维护理想的环境”相比，生活在“维护不太理想的环境”中的个体出现这两种不良结果的可能性明显更高。本文讨论了用于评估物理环境的六个项目的局限性，以及提高这些项目的敏感性从而避免测量偏差的方法。
