Murata Chiyoe, Kondo Takaaki, Tamakoshi Koji, Yatsuya Hiroshi, Toyoshima Hideaki
Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka 431-3192, Japan.
Arch Gerontol Geriatr. 2006 Nov-Dec;43(3):369-80. doi: 10.1016/j.archger.2006.01.002. Epub 2006 Mar 13.
The purpose of this study was to investigate factors related to self-rated health and to mortality among 2490 community-living elderly. Respondents were followed for 7.3 years for all-cause mortality. To compare the relative impact of each variable, we employed logistic regression analysis for self-rated health and Cox hazard analysis for mortality. Cox analysis stratified by gender, follow-up periods, age group, and functional status was also employed. Series of analysis found that factors associated with self-rated health and with mortality were not identical. Psychological factors such as perceived isolation at home or 'ikigai (one aspect of psychological well-being)' were associated with self-rated health only. Age, functional status, and social relations were associated both with self-rated health and mortality after controlling for possible confounders. Illnesses and functional status accounted for 35-40% of variances in the fair/poor self-rated health. Differences by gender and functional status were observed in the factors related to self-rated health. Overall, self-rated health effect on mortality was stronger for people with no functional impairment, for shorter follow-up period, and for young-old age group. Although, illnesses and functional status were major determinants of self-rated health, economical, psychological, and social factors were also related to self-rated health.
本研究旨在调查2490名社区居住老年人中与自评健康及死亡率相关的因素。对受访者进行了7.3年的全因死亡率随访。为比较各变量的相对影响，我们对自评健康采用逻辑回归分析，对死亡率采用Cox风险分析。还采用了按性别、随访期、年龄组和功能状态分层的Cox分析。一系列分析发现，与自评健康和死亡率相关的因素并不相同。诸如在家中感到孤独或“生活意义（心理健康的一个方面）”等心理因素仅与自评健康相关。在控制了可能的混杂因素后，年龄、功能状态和社会关系与自评健康和死亡率均相关。疾病和功能状态占自评健康为“一般/较差”的方差的35 - 40%。在与自评健康相关的因素中观察到了性别和功能状态的差异。总体而言，对于无功能障碍者、随访期较短者以及年轻老年人组，自评健康对死亡率的影响更强。尽管疾病和功能状态是自评健康的主要决定因素，但经济、心理和社会因素也与自评健康相关。
