Fujino Yoshihisa, Matsuda Shinya
Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Iseigaoka, Yahatanishiku, Kitakyushu, Japan.
Prev Med. 2009 Jan;48(1):79-85. doi: 10.1016/j.ypmed.2008.10.014. Epub 2008 Oct 29.
In light of recent concerns regarding informal care, we examined the association between living arrangement and survival among elderly Japanese, with living arrangement measured in terms of the ability to receive informal care from the immediate family.
A total of 3000 subjects aged 60 years or older were randomly recruited in Yukuhashi City, Japan, in 2002, of whom 2773 provided complete information for analysis. A trained local welfare commissioner visited the subjects annually from 2002 to 2007 and collected information concerning living arrangements, mobility status, medical status, and use of long-term care insurance service. During the 5 years of follow-up, 381 deaths were recorded.
Living arrangement was not associated with survival among elderly women. In contrast, compared with men living with others able to provide care throughout the day, mortality was higher for those living with others unable to provide sufficient care due to illness or infirmity; those living with others receiving long-term care insurance service; and those living alone without support from family or friends (multivariable hazard ratio=1.40, 95% Confidence Interval 0.94-2.09; hazard ratio=1.89, 95% Confidence Interval 1.07-3.34; and hazard ratio=5.76, 95% Confidence Interval 2.16-15.36; respectively).
We found that living arrangement as classified by the ability to receive informal care affects survival among elderly men.
鉴于近期对非正式照护的关注,我们研究了日本老年人的居住安排与生存之间的关联,居住安排依据从直系亲属获得非正式照护的能力来衡量。
2002年在日本直方市随机招募了3000名60岁及以上的受试者,其中2773人提供了完整的分析信息。一名经过培训的当地福利专员在2002年至2007年期间每年走访这些受试者,收集有关居住安排、活动能力状况、医疗状况以及长期护理保险服务使用情况的信息。在5年的随访期间,记录了381例死亡病例。
居住安排与老年女性的生存无关。相比之下,与全天都有能力提供照护的他人共同居住的男性相比,因疾病或体弱而与无法提供充分照护的他人共同居住的男性、接受长期护理保险服务的他人共同居住的男性以及没有家人或朋友支持而独自居住的男性死亡率更高(多变量风险比分别为1.40,95%置信区间0.94 - 2.09;风险比为1.89,95%置信区间1.07 - 3.34;风险比为5.76,95%置信区间2.16 - 15.36)。
我们发现,根据获得非正式照护的能力分类的居住安排会影响老年男性的生存。