Stessman Jochanan, Hammerman-Rozenberg Robert, Maaravi Yoram, Cohen Aaron
Department of Rehabilitation and Geriatrics, Hadassah-University Hospital, Mt. Scopus, Jerusalem, Israel.
J Am Geriatr Soc. 2002 Dec;50(12):1934-8. doi: 10.1046/j.1532-5415.2002.50603.x.
To determine the prevalence of independence and ease of performance in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) at ages 70 and 77 in a well-characterized cohort and to measure the effect of regular exercise at age 70 on independence and ease of performance 7 years later.
Two stages of a longitudinal study of an age-homogeneous cohort employing extensive interview data, physical examination, and clinical laboratory investigation.
Home-based interviews and examinations in Jerusalem.
Two hundred eighty-seven west Jerusalem residents, born between June 1920 and May 1921, who participated fully in two phases of an ongoing longitudinal cohort study. Subjects were culled from a larger study population of 605 in the first phase and 1,021 in the second phase.
Two-stage comprehensive demographic, social, and economic profile; medical history and examination; cognitive and affective assessment; and clinical laboratory studies performed in 1990-91 and 1997-98. The investigation questionnaire included details of ADL and IADLs and voluntary exercise.
Most aspects of personal and social life did not change from age 70 to 77. Independence in ADLs remained high, as did self-reliance in IADLs for women. A more-sensitive marker of diminished function was reported ease in performance, which declined for use of the toilet, dressing, and all spheres of IADLs. For nearly every task, subjects who reported exercising 4 days a week at age 70 were more likely to report ease in performance at age 77. In a logistic regression accounting for the presence of diabetes mellitus, hypertension, obesity, chronic back pain, loneliness, and performance with ease at age 70 and deterioration in self-assessed health from age 70 to 77, ease of performance in at least three of four ADL tasks was independently related to exercise at age 70 for women (odds ratio (OR) = 8.5, 95% confidence interval (CI) = 2.0-36.2) and for men (OR = 4.3, 95% CI = 1.1-17.1). Ease of independent function in at least four of five IADL tasks also correlated to exercise for men in this regression (OR = 3.7, 95% CI = 1.1-12.2) but not for women (OR = 2.0, 95% CI = 0.6-6.3). Ease in shopping, alternatively, correlated with physical activity for men (OR = 4.3, 95% CI = 1.5-12.0) and women (OR = 2.6, 95% CI = 1.1-6.1).
Subjects remained active and independent at age 77. Reported ease of performance declined and revealed changes in function. Exercise at least four times a week at age 70 preserved ease of performance at age 77 independent of the influence of specific disease or general self-assessed health.
确定在一个特征明确的队列中，70岁和77岁时日常生活活动（ADL）及工具性日常生活活动（IADL）的独立程度和执行难易程度，并衡量70岁时定期锻炼对7年后独立程度和执行难易程度的影响。
对一个年龄同质队列进行的纵向研究的两个阶段，采用广泛的访谈数据、体格检查和临床实验室调查。
耶路撒冷的家庭访谈和检查。
287名西耶路撒冷居民，出生于1920年6月至1921年5月，他们充分参与了一项正在进行的纵向队列研究的两个阶段。受试者从第一阶段的605名和第二阶段的1021名更大的研究人群中挑选出来。
1990 - 91年和1997 - 98年进行的两阶段综合人口统计学、社会和经济概况；病史和检查；认知和情感评估；以及临床实验室研究。调查问卷包括ADL和IADL的详细信息以及自愿锻炼情况。
从70岁到77岁，个人和社会生活的大多数方面没有变化。ADL的独立性仍然很高，女性在IADL方面的自理能力也是如此。报告的执行难易程度是功能下降的一个更敏感指标，在使用厕所、穿衣和IADL的所有方面都有所下降。对于几乎每一项任务，报告在70岁时每周锻炼4天的受试者在77岁时更有可能报告执行轻松。在一项逻辑回归分析中，考虑到糖尿病、高血压、肥胖、慢性背痛、孤独感以及70岁时的执行轻松程度和从70岁到77岁自我评估健康状况的恶化情况，女性在四项ADL任务中至少三项的执行轻松程度与70岁时的锻炼独立相关（优势比（OR）= 8.5，95%置信区间（CI）= 2.0 - 36.2），男性也是如此（OR = 4.3，95% CI = 1.1 - 17.1）。在该回归分析中，男性在五项IADL任务中至少四项的独立功能轻松程度也与锻炼相关（OR = 3.7，95% CI = 1.1 - 12.2），但女性并非如此（OR = 2.0，95% CI = 0.6 - 6.3）。另外，购物轻松程度与男性（OR = 4.3，95% CI = 1.5 - 12.0）和女性（OR = 2.6，95% CI = 1.1 - 6.1）的身体活动相关。
受试者在77岁时仍然活跃且独立。报告的执行轻松程度下降并揭示了功能变化。70岁时每周至少锻炼四次可保持77岁时的执行轻松程度，不受特定疾病或总体自我评估健康状况的影响。
