Evans Jennifer R, Smeeth Liam, Fletcher Astrid E
International Centre for Eye Health, Non-Communicable DiseaseEpidemiology Unit, London School of Hygiene and Tropical Medicine, London, England.
Arch Ophthalmol. 2008 Oct;126(10):1428-33. doi: 10.1001/archopht.126.10.1428.
To assess the risk of nursing home admission in a representative sample of older, visually impaired, community-dwelling people 75 years and older living in Great Britain.
Prospective study.
General practices (n = 53).
Participants in the Medical Research Council trial of assessment and management of older people in the community (N = 14 037). Main Outcome Measure Nursing home admission (nursing or residential care).
After a mean of 4 years' follow-up, 14.1% of visually impaired participants were living in nursing homes (95% confidence interval [CI], 11.9%-16.3%; age- and sex-adjusted risk ratio, 1.47 [95% CI, 1.25-1.73]). Adjusting for a wide range of confounding factors eliminated this significant association (risk ratio, 1.08 [95% CI, 0.91-1.28]).
The association between visual impairment and risk of nursing home admission was eliminated after controlling for a wide range of other confounding factors and comorbidities. This underlines the importance of taking a wider view of an older person's health rather than focusing on a single impairment or disability.
评估居住在英国的75岁及以上视力受损的社区老年人代表性样本中入住养老院的风险。
前瞻性研究。
全科医疗诊所(n = 53)。
医学研究委员会社区老年人评估与管理试验的参与者(N = 14037)。主要结局指标为入住养老院(护理或寄宿照料)。
经过平均4年的随访,14.1%的视力受损参与者居住在养老院(95%置信区间[CI],11.9%-16.3%;年龄和性别调整后的风险比为1.47[95%CI,1.25-1.73])。对一系列混杂因素进行调整后,这种显著关联消失(风险比为1.08[95%CI,0.91-1.28])。
在控制了一系列其他混杂因素和合并症后,视力受损与入住养老院风险之间的关联消失。这凸显了全面看待老年人健康状况而非仅关注单一损伤或残疾的重要性。