Colvez A, Castex A, Carriere I
Unité 500, Epidémiologie des maladies chroniques et du vieillissement, Institut National de la Santé et de la Recherche Médicale, 39, avenue Charles-Flahault, 34093 Montpellier Cedex 5.
Rev Epidemiol Sante Publique. 2003 Dec;51(6):565-73.
The recovery of people initially disabled was addressed using the National Institute of Health and Medical Research Upper-Normandy survey, conducted on a representative sample of the older population from 1978 to 1999.
The survey was based on 1082 older people aged 65 and over. A follow-up was organized to register mortality and disability at point 3, 6, 10 and 20 years. Among the persons initially disabled were taken into account those who were able to go outside their home without help during the 20-year follow-up. Each case of recovery was validated.
Among the 1046 subjects for whom data could be analyzed, 218 presented mobility disability necessitating help to go outside their home. Recovery from disability was observed in 23 subjects (10.5%; CI: 6.5-14.5). Among the 195 subjects (89.5%) without any recovery, 107 (49%) had died before 4 years, 44 (20%) had died between 4 and 6 years, and 44 (20%) survived with disability more than 6 years. The rate of recovery was 18.6% before age 80, and 4.1% for people aged 80 and over. It was 1.3% for home-confined or bed- or chair-confined people and 15.4% for the others. Before age 80 the recovery rate was significantly higher in women. No recovery was observed for people with mental deterioration. Cerebrovascular diseases were significantly associated with a low rate of recovery (5%).
Recovery from disability should be taken into account for the health prospects of the elderly population. It concerns about one person out of five before the age of 80. Increased rate of recovery after the age of 80 should be one of the objectives for the health system in the future.
利用法国国家健康与医学研究院上诺曼底地区调查,对1978年至1999年老年人群的代表性样本进行研究,以探讨最初残疾者的恢复情况。
该调查基于1082名65岁及以上的老年人。组织了随访,以记录第3、6、10和20年时的死亡率和残疾情况。在最初残疾的人群中,纳入了那些在20年随访期间能够在无帮助的情况下走出家门的人。每例恢复情况均得到验证。
在可分析数据的1046名受试者中,218人存在行动障碍,需要帮助才能走出家门。23名受试者(10.5%;置信区间:6.5 - 14.5)实现了残疾恢复。在195名(89.5%)未恢复的受试者中,107人(49%)在4年前死亡,44人(20%)在4至6年之间死亡,44人(20%)残疾存活超过6年。80岁之前的恢复率为18.6%,80岁及以上人群为4.1%。居家受限或卧床或坐轮椅受限者的恢复率为1.3%,其他人为15.4%。80岁之前女性的恢复率显著更高。精神衰退者未观察到恢复情况。脑血管疾病与低恢复率(5%)显著相关。
残疾恢复情况应纳入老年人群健康前景的考量。80岁之前约五分之一的人会出现这种情况。提高80岁之后的恢复率应成为未来卫生系统的目标之一。