健康多维度方面的地区差异：医学研究委员会认知功能与衰老研究的结果
Regional differences in multidimensional aspects of health: findings from the MRC cognitive function and ageing study.
作者信息
Matthews Fiona E, Miller Laura L, Brayne Carol, Jagger Carol
机构信息
MRC Biostatistics Unit, Institute of Public Health, Cambridge, CB2 2SR, UK.
出版信息
BMC Public Health. 2006 Apr 6;6:90. doi: 10.1186/1471-2458-6-90.
BACKGROUND
Differences in mortality and health experience across regions are well recognised and UK government policy aims to address this inequality. Methods combining life expectancy and health have concentrated on specific areas, such as self-perceived health and dementia. Few have looked within country or across different areas of health. Self-perceived health, self-perceived functional impairment and cognitive impairment are linked closely to survival, as well as quality of life. This paper aims to describe regional differences in healthy life expectancy using a variety of states of health and wellbeing within the MRC Cognitive Function and Ageing Study (MRC CFAS).
METHODS
MRC CFAS is a population based study of health in 13,009 individuals aged 65 years and above in five centres using identical study methodology. The interviews included self-perceived health and measures of functional and cognitive impairment. Sullivan's method was used to combine prevalence rates for cognitive and functional impairment and life expectancy to produce expectation of life in various health states.
RESULTS
The prevalence of both cognitive and functional impairment increases with age and was higher in women than men, with marked centre variation in functional impairment (Newcastle and Gwynedd highest impairment). Newcastle had the shortest life expectancy of all the sites, Cambridgeshire and Oxford the longest. Centre differences in self-perceived health tended to mimic differences in life expectancy but this did not hold for cognitive or functional impairment.
CONCLUSION
Self-perceived health does not show marked variation with age or sex, but does across centre even after adjustment for impairment burden. There is considerable centre variation in self-reported functional impairment but not cognitive impairment. Only variation in self-perceived health relates to the ranking of life expectancy. These data confirm that quite considerable differences in life experience exist across regions of the UK beyond basic life expectancy.
背景
不同地区在死亡率和健康状况方面的差异已得到充分认识，英国政府政策旨在解决这种不平等问题。结合预期寿命和健康状况的方法主要集中在特定领域，如自我感知健康和痴呆症。很少有人在国内或不同健康领域进行研究。自我感知健康、自我感知功能障碍和认知障碍与生存以及生活质量密切相关。本文旨在利用医学研究委员会认知功能与衰老研究（MRC CFAS）中各种健康和幸福状态来描述健康预期寿命的地区差异。
方法
MRC CFAS是一项基于人群的研究，对五个中心的13009名65岁及以上个体的健康状况进行调查，采用相同的研究方法。访谈内容包括自我感知健康以及功能和认知障碍的测量。采用沙利文方法结合认知和功能障碍的患病率以及预期寿命，得出不同健康状态下的预期寿命。
结果
认知和功能障碍的患病率均随年龄增长而增加，女性高于男性，功能障碍在各中心存在显著差异（纽卡斯尔和格温内德的障碍率最高）。纽卡斯尔在所有地点中预期寿命最短，剑桥郡和牛津最长。自我感知健康的中心差异往往与预期寿命的差异相似，但在认知或功能障碍方面并非如此。
结论
自我感知健康在年龄或性别方面没有显著差异，但即使在调整障碍负担后，各中心之间仍存在差异。自我报告的功能障碍在各中心存在相当大的差异，但认知障碍并非如此。只有自我感知健康的差异与预期寿命的排名有关。这些数据证实，除了基本预期寿命外，英国不同地区的生活经历存在相当大的差异。
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