Fujita Koji, Fujiwara Yoshinori, Chaves Paulo H M, Motohashi Yutaka, Shinkai Shoji
Research Team for Social Participation and Health Promotion, Tokyo Metropolitan Institute of Gerontology, Tokyo.
J Epidemiol. 2006 Nov;16(6):261-70. doi: 10.2188/jea.16.261.
The clinico-epidemiologic relevance of the reduction in the frequency of going outdoors in older adults has not been well characterized. This study examined whether the frequency of going outdoors has predictive values for incident physical disability and recovery among community-dwelling elderly.
One thousand, two hundred and sixty-seven persons aged 65+ years who lived in a rural community in Niigata, Japan, and participated in the baseline survey were assessed again 2 years later in terms of mobility, and instrumental and basic activities of daily living (IADL and BADL). We compared the incident disability and recovery at follow-up among three subgroups classified by the baseline frequency of going outdoors: once a day or more often, once per 2-3 days, and once a week or less often. Multivariate analyses tested associations between the frequency of going outdoors and functional transition, independent of potential confounders.
A lower frequency of going outdoors at baseline was associated with a greater incident disability, and a lower recovery at the two-year follow-up. Even after adjustment, the effects of going outdoors remained significant. Adjusted risks of incident mobility and IADL disabilities were significantly higher (odds ratio[OR]=4.02, 95% confidence interval [CI]: 1.77-9.14 and OR=2.65, 95% CI: 1.06-6.58), respectively, and recovery from mobility disability was significantly lower (OR=0.29, 95% CI: 0.08-0.99) for "once a week or less often" subgroup compared with "once a day or more often" subgroup.
The frequency of going outdoors is a good predictor for incident physical disability and recovery among community-living elderly. Public health nurses and clinicians should pay more attention how often their senior clients usually go outdoors.
老年人户外活动频率降低的临床流行病学相关性尚未得到充分描述。本研究探讨了户外活动频率对社区居住老年人身体残疾发生及恢复情况是否具有预测价值。
对居住在日本新潟农村社区、年龄在65岁及以上且参与基线调查的1267人,于2年后再次进行了行动能力、工具性日常生活活动和基本日常生活活动(IADL和BADL)方面的评估。我们比较了根据户外活动基线频率划分的三个亚组在随访时的残疾发生情况和恢复情况:每天一次或更频繁、每2 - 3天一次、每周一次或更少。多变量分析检验了户外活动频率与功能转变之间的关联,同时考虑了潜在的混杂因素。
基线时较低的户外活动频率与更大的残疾发生率以及两年随访时较低的恢复率相关。即使经过调整,户外活动的影响仍然显著。与“每天一次或更频繁”亚组相比,“每周一次或更少”亚组发生行动能力和IADL残疾的调整后风险显著更高(优势比[OR]=4.02,95%置信区间[CI]:1.77 - 9.14和OR = 2.65,95% CI:1.06 - 6.58),且行动能力残疾恢复的比例显著更低(OR = 0.29,95% CI:0.08 - 0.99)。
户外活动频率是社区居住老年人身体残疾发生及恢复情况的良好预测指标。公共卫生护士和临床医生应更多关注老年患者的户外活动频率。