Gill Thomas M, Allore Heather, Guo Zhenchao
Yale University School of Medicine, Dorothy Adler Geriatric Assessment Center, 20 York Street, New Haven, CT 06504, USA.
J Gerontol A Biol Sci Med Sci. 2004 Jul;59(7):755-61. doi: 10.1093/gerona/59.7.m755.
Older persons often "take to bed" while they are ill or injured, but relatively little is known about the functional consequences of bed rest among community-living older persons. In this prospective cohort study, the association between episodes of bed rest and functional decline was evaluated during an 18-month period.
Participants included 680 nondisabled, community-living persons aged 70 years or older. They were separated into 2 groups according to the presence or absence of physical frailty, which was defined based on slow gait speed. Episodes of bed rest were ascertained each month in a telephone interview for a median of 18 months. The completion rate was 99.1%. Functional decline was defined as a worsening in scores between the baseline and 18-month follow-up assessments in 1 or more of the following measures: instrumental activities of daily living, mobility, physical activity, and social activity.
Among the 404 (59.4%) participants who had at least 1 episode of bed rest, the mean number of months with bed rest was 2.8 (standard deviation, 2.4). After adjustments were made for several potential confounders, the number of months with bed rest was significantly associated with decline in each of the functional measures. Significant associations were also observed for each of the functional outcomes among participants who were not physically frail, but they were observed only for instrumental activities of daily living disability among participants who were physically frail.
These findings indicate that episodes of bed rest among community-living older persons are associated with decline in several important indicators of function.
老年人在生病或受伤时常常“卧床”，但对于社区居住的老年人而言，卧床休息对功能的影响却知之甚少。在这项前瞻性队列研究中，对18个月期间卧床休息次数与功能衰退之间的关联进行了评估。
参与者包括680名年龄在70岁及以上、居住在社区且无残疾的人。根据是否存在身体虚弱将他们分为两组，身体虚弱根据步态缓慢来定义。通过每月一次的电话访谈确定卧床休息次数，访谈时间中位数为18个月。完成率为99.1%。功能衰退定义为在以下一项或多项指标的基线评估与18个月随访评估之间得分变差：日常生活工具性活动、活动能力、身体活动和社交活动。
在至少有1次卧床休息经历的404名（59.4%）参与者中，卧床休息的平均月数为2.8（标准差为2.4）。在对几个潜在混杂因素进行调整后，卧床休息的月数与各项功能指标的衰退均显著相关。在身体不虚弱的参与者中，各项功能结局也观察到显著关联，但在身体虚弱的参与者中，仅在日常生活工具性活动残疾方面观察到显著关联。
这些发现表明，社区居住的老年人卧床休息与几个重要功能指标的衰退有关。
