Blaum Caroline S, Ofstedal Mary Beth, Liang Jersey
Department of Internal Medicine, University of Michigan, Ann Arbor, USA.
J Gerontol A Biol Sci Med Sci. 2002 Aug;57(8):M523-31. doi: 10.1093/gerona/57.8.m523.
This research evaluated the association of low cognitive performance with both chronic diseases and conditions, and with difficulties in a broad array of task-specific functioning and disability measures in older adults living in the community.
Data were from the first wave of the Assets and Health Dynamics Among the Oldest-Old Study, a national panel survey of individuals age 70 and older (n = 6600 age-eligible self-respondents). Low cognitive performance (LCP) was defined as scores in the lowest (poorest performing) 25th percentile of a cognitive performance scale. The associations of LCP with prevalent chronic diseases and conditions and with limitations in 14 tasks (strength and mobility, instrumental activities of daily living, and activities of daily living) were evaluated. Associations of LCP and task limitations were adjusted for potential modifiers and confounders, including demographic characteristics (age, gender, race), educational attainment, chronic diseases, depressive symptoms, and sensory impairments. Data were weighted to account for complex sample design and nonresponse.
More than one third of people with LCP had three or more coexisting diseases and conditions. The unadjusted associations of LCP with task functioning were attenuated after covariate adjustment, but even after adjustment, LCP remained significantly and independently associated with functioning problems in 9 of 14 tasks (borderline with four more), including mobility tasks.
Low cognitive performance, regardless of its relationship to clinical dementia, coexists with multiple chronic diseases and conditions. It is independently associated with a broad array of functioning difficulties, even after controlling for demographic characteristics, educational attainment, and chronic conditions. Chronic diseases and conditions, however, attenuate the relationship between LCP and some task difficulties. LCP should be considered an important comorbid condition associated with both chronic diseases and disability that substantially increases the health burden of many older adults who are poorly equipped to handle it.
本研究评估了认知功能低下与慢性疾病和状况之间的关联，以及与社区中老年人一系列特定任务功能和残疾测量方面困难之间的关联。
数据来自“高龄老人资产与健康动态研究”的第一波调查，这是一项针对70岁及以上人群的全国性面板调查（n = 6600名符合年龄条件的自填受访者）。认知功能低下（LCP）被定义为认知表现量表中得分处于最低（表现最差）的第25百分位。评估了LCP与常见慢性疾病和状况以及14项任务（力量和活动能力、日常生活工具性活动以及日常生活活动）受限之间的关联。对LCP与任务受限之间的关联进行了潜在调节因素和混杂因素的校正，包括人口统计学特征（年龄、性别、种族）、教育程度、慢性疾病、抑郁症状和感觉障碍。对数据进行加权以考虑复杂的样本设计和无应答情况。
超过三分之一的认知功能低下者患有三种或更多并存的疾病和状况。在进行协变量校正后，LCP与任务功能之间未经调整的关联减弱，但即使在调整后，LCP在14项任务中的9项（另外4项接近临界值），包括活动能力任务，仍与功能问题显著且独立相关。
认知功能低下，无论其与临床痴呆的关系如何，都与多种慢性疾病和状况并存。即使在控制了人口统计学特征、教育程度和慢性疾病之后，它仍与广泛的功能困难独立相关。然而，慢性疾病和状况会减弱LCP与某些任务困难之间的关系。LCP应被视为与慢性疾病和残疾相关的重要共病状况，这在很大程度上增加了许多应对能力不足的老年人的健康负担。
Zotero 插件