Starr John M, Deary Ian J, Whalley Lawrence J
Geriatric Medicine Unit, University of Edinburgh, Edinburgh, UK.
BMC Public Health. 2008 Sep 10;8:307. doi: 10.1186/1471-2458-8-307.
Childhood intelligence predicts mortality throughout most of the life span. However, it is unknown whether its effect persists into advanced old age.
The Aberdeen Birth Cohort born in 1921 (n = 354) and that had an IQ test as part of the national Scottish Mental Survey of 1932 were seen in 1997 at age 76 years when childhood and adult socio-environmental, medical and cognitive data were collected. Participants were followed until May 2007 and vital status determined from the General Register for Scotland records. Univariate associations between baseline variables and mortality were determined and multivariable survival analysis performed with Cox's proportional hazards modelling.
One hundred and fifty-eight (44.6%) of the 354 cohort members had died by the census date. Significantly more men (n = 102) died during follow-up than women (n = 56, chi2 = 5.27, p = .022). Lower scores on four of the six cognitive tests at age 76 years were associated with increased mortality, but not IQ age 11. Survival was associated with gender (H.R. 0.32, 95% C.I. 0.11-0.89 for women versus men), peak expiratory flow rate (H.R. 0.997, 95% C.I. 0.992-1.001 per l/min) and the Uses of Common Objects test (H.R. 0.91, 95% C.I. 0.82-1.01)
Both physical and psychological variables independently predicted survival in old age: respiratory function and executive function in particular. Male gender conferred increased risk of mortality and this was not explained by the broad range of socio-environmental, mental ability and health status variables examined in the study.
儿童期智力可预测生命大部分阶段的死亡率。然而,其影响是否持续至高龄尚不清楚。
1921年出生的阿伯丁出生队列(n = 354),在1932年苏格兰全国智力调查中接受了智商测试,于1997年76岁时接受随访,收集了儿童期和成年期的社会环境、医学及认知数据。对参与者进行随访直至2007年5月,并根据苏格兰总登记处记录确定其生命状态。确定基线变量与死亡率之间的单变量关联,并采用Cox比例风险模型进行多变量生存分析。
在354名队列成员中,有158名(44.6%)在普查日期前死亡。随访期间死亡的男性(n = 102)显著多于女性(n = 56,卡方 = 5.27,p = 0.022)。76岁时六项认知测试中的四项得分较低与死亡率增加相关,但11岁时的智商则不然。生存与性别(女性与男性相比,风险比为0.32,95%置信区间为0.11 - 0.89)、呼气峰值流速(每升/分钟风险比为0.997,95%置信区间为0.992 - 1.001)以及普通物体使用测试(风险比为0.91,95%置信区间为0.82 - 1.01)有关。
身体和心理变量均可独立预测老年生存情况:尤其是呼吸功能和执行功能。男性性别增加了死亡风险,而本研究中所考察的广泛社会环境、心理能力和健康状况变量并不能解释这一现象。