Okamoto Nozomi, Morita Noriko, Saeki Keigo, Matsuda Ryozo, Kurumatani Norio
Department of Hygiene, Nara Medical University School of Medicine, Kashihara-shi, Nara 634-8521, Japan.
Arch Gerontol Geriatr. 2006 Mar-Apr;42(2):175-89. doi: 10.1016/j.archger.2005.06.012. Epub 2005 Oct 10.
The present study was conducted to characterize the lifestyles and health status of non-participants and to investigate whether diminished higher-level functional capacity may cause selection bias in non-compulsory mass health screening for the elderly. Using a self-administered questionnaire for evaluating the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG Index of Competence) which consists of three sublevels, namely, instrumental self-maintenance, intellectual activity and social role, we conducted a survey of 1543 (mean age, 64.9+/-12.5 years, 677 males and 866 females) out of all the 1701 individuals over the age of 40 residing in a village where mass health screening is conducted annually. The mean TMIG Index of Competence score was the highest in Group V (composed of 434 individuals who participated in the mass health screening conducted by the village), followed, in that order, by the score in Group W (composed of 531 individuals who had undergone a health checkup organized at their workplaces or by their family physicians, but not the one conducted by the village, during the previous year) and that in Group N (composed of 578 individuals who had not undergone any health checkup during the previous year). Group N showed a significantly lower mean TMIG Index of Competence score than Groups V and W. In regard to the scores for the sublevels of the index, Group N had a significantly lower percentage of subjects, both men and women, with perfect scores than Group V for all the sublevels, and also a significantly lower percentage of subjects with a perfect score for the intellectual activity than Group W. However, there were no significant differences in the percentages of subjects habituated to exercise, drinking or smoking among the three groups. Thus, special attention may need to be paid to selection bias in mass health screenings caused by differences in the higher-level functional capacity.
本研究旨在描述未参与者的生活方式和健康状况，并调查在针对老年人的非强制性大规模健康筛查中，较高水平功能能力的下降是否可能导致选择偏倚。我们使用一份用于评估东京都老人综合研究所能力指数（TMIG能力指数）的自填式问卷进行调查，该指数由三个子水平组成，即工具性自我维持、智力活动和社会角色。在一个每年进行大规模健康筛查的村庄中，我们对居住在该村的1701名40岁以上人群中的1543人（平均年龄64.9±12.5岁，男性677人，女性866人）进行了调查。TMIG能力指数的平均得分在第五组（由434名参加村庄组织的大规模健康筛查的个体组成）中最高，其次依次是W组（由531名在前一年接受过工作场所或家庭医生组织的健康检查，但未参加村庄组织的健康检查的个体组成）和N组（由578名在前一年未接受任何健康检查的个体组成）。N组的TMIG能力指数平均得分显著低于V组和W组。关于该指数子水平的得分，N组在所有子水平上，无论男性还是女性，获得满分的受试者百分比均显著低于V组，并且在智力活动方面获得满分的受试者百分比也显著低于W组。然而，三组之间在习惯锻炼、饮酒或吸烟的受试者百分比方面没有显著差异。因此，可能需要特别关注由较高水平功能能力差异导致的大规模健康筛查中的选择偏倚。
