Kaplan Mark S, Huguet Nathalie, Orpana Heather, Feeny David, McFarland Bentson H, Ross Nancy
School of Community Health, Portland State University, P.O. Box 751, Portland, OR 97207, USA.
J Gerontol A Biol Sci Med Sci. 2008 Oct;63(10):1097-104. doi: 10.1093/gerona/63.10.1097.
Interest in the determinants of "successful aging" is growing. Nonetheless, successful aging remains ill defined, and its appropriate measurement is hotly contested. Most studies have focused on the absence of disability or deficits in physical performance as outcomes. The present study extends this research by using the Health Utilities Index Mark 3 (HUI3), a multidimensional measure of health status, to examine the maintenance of exceptionally good health among older participants in the Canadian National Population Health Survey (1994--2004).
The maintenance of exceptionally good health in old age was examined prospectively among 2432 individuals (65-85 years old at baseline) who met the inclusion criteria. The participants were classified into one of four health trajectories: thrivers (who maintained exceptional health with no or only mild disability), nonthrivers (who experienced a moderate or severe disability), the deceased, and the institutionalized.
In 10 years of follow-up, 190 (8%) were thrivers (HUI3 score > or = 0.89 at all interviews), 1076 (47%) were nonthrivers, 893 (36%) died, and 273 (9%) were institutionalized. The maintenance of exceptionally good health among the elderly participants was related to younger age at baseline, socioeconomic status (higher income), psychosocial factors (including lower psychological distress), and behavioral factors (never smoked and moderate alcohol use).
The maintenance of exceptionally good health in old age is related, at least in part, to modifiable lifestyle factors. However, elevated socioeconomic status also distinguishes those who are able to maintain exceptionally good health.
对“成功老龄化”决定因素的关注日益增加。尽管如此，成功老龄化的定义仍不明确，其恰当的衡量标准也备受争议。大多数研究将身体功能无残疾或缺陷作为结果。本研究通过使用健康效用指数Mark 3（HUI3）这一健康状况的多维测量方法，对加拿大国家人口健康调查（1994 - 2004年）中老年参与者的极佳健康状况维持情况进行了扩展研究。
对符合纳入标准的2432名个体（基线年龄65 - 85岁）进行前瞻性研究，以考察老年时极佳健康状况的维持情况。参与者被分为四种健康轨迹之一：健康良好者（维持极佳健康状况，无残疾或仅有轻度残疾）、非健康良好者（经历中度或重度残疾）、死亡者和入住机构者。
在10年的随访中，190人（8%）为健康良好者（所有访谈时HUI3评分≥0.89），1076人（47%）为非健康良好者，893人（36%）死亡，273人（9%）入住机构。老年参与者中极佳健康状况的维持与基线时较年轻的年龄、社会经济地位（较高收入）、心理社会因素（包括较低的心理困扰）和行为因素（从不吸烟和适度饮酒）有关。
老年时极佳健康状况的维持至少部分与可改变的生活方式因素有关。然而，较高的社会经济地位也使那些能够维持极佳健康状况的人有所不同。
