Suárez García Francisco Manuel, Pérez Martín Alejando, Peiró Moreno Salvador, García García Francisco José
Geriatría, Consejería de Salud y Servicios Sanitarios, Oviedo, Asturias, España.
Rev Esp Geriatr Gerontol. 2008 Mar-Apr;43(2):76-84. doi: 10.1016/s0211-139x(08)71159-4.
multiple factors contribute to mortality in older adults. Measures of physical and cognitive function are strong predictors of mortality, but the extent to which function, health-related quality of life and other factors contribute independently to mortality risk is not known.
we performed a prospective study of a representative sample of people aged 65 years and older (n=3,214) followed-up for 4 years. Individuals from the sample were interviewed to obtain information about sociodemographic characteristics, comorbidity, functional status, health-related quality of life, and healthcare utilization. The main outcome measure was 4-year mortality. To assess the independent impact of each risk factor on mortality, several multivariate survival models were built using the Cox proportional hazard model.
in the 4 years of monitoring, 478 people died (14.9%). The variables independently associated with mortality risk were age 75 years or older (HR = 1.93), male gender (HR = 1.73), heart disease (HR = 1.32), chronic respiratory disease (HR = 1.78), activities of daily living disability (HR = 1.55), instrumental activities of daily living disability (HR = 2.19), cognitive impairment (HR = 1.39), poor health-related quality of life (HR = 1.85) and hospital admission in the year prior to the interview (HR = 1.51).
objective measures of physical and cognitive function are independent predictors of 4-year mortality in the elderly. Poor health-related quality of life is associated with mortality. The magnitude of this association is comparable to that of other well-know predictors of mortality. Instruments to measure health-related quality of life can be useful to evaluate health requirements in the elderly.
多种因素导致老年人死亡。身体和认知功能的指标是死亡率的有力预测因素，但功能、健康相关生活质量及其他因素对死亡风险的独立影响程度尚不清楚。
我们对65岁及以上具有代表性的人群样本（n = 3214）进行了为期4年的前瞻性研究。对样本中的个体进行访谈，以获取有关社会人口学特征、合并症、功能状态、健康相关生活质量和医疗保健利用的信息。主要结局指标是4年死亡率。为评估每个风险因素对死亡率的独立影响，使用Cox比例风险模型建立了多个多变量生存模型。
在4年的监测期内，478人死亡（14.9%）。与死亡风险独立相关的变量有75岁及以上年龄（HR = 1.93）、男性（HR = 1.73）、心脏病（HR = 1.32）、慢性呼吸道疾病（HR = 1.78）、日常生活活动能力障碍（HR = 1.55）、工具性日常生活活动能力障碍（HR = 2.19）、认知障碍（HR = 1.39）、健康相关生活质量差（HR = 1.85）以及访谈前一年住院（HR = 1.51）。
身体和认知功能的客观指标是老年人4年死亡率的独立预测因素。健康相关生活质量差与死亡率相关。这种关联的程度与其他知名死亡率预测因素相当。测量健康相关生活质量的工具可用于评估老年人的健康需求。
