Research Center, Montreal Geriatric University Institute, 4565 Queen Mary, Montreal, (Quebec), H3W 1W5 Canada.
Arch Gerontol Geriatr. 2011 Jan-Feb;52(1):12-7. doi: 10.1016/j.archger.2009.11.003. Epub 2009 Nov 28.
The purpose of this study was to investigate transitions over time in the functional status of disabled community-living elderly. The study explored clinical and socio-demographic predictors of functional status decline. Data from the SIPA 3-year longitudinal study were analyzed (n=1164). Three categories of functional status were defined: no important disability, significant IADL disability and significant ADL disability. At baseline, results show that the prevalence rates were 26.9%, 58.6% and 14.5% for the three categories of functional status. After 12 months, about 50-60% of participants had remained in the same status, while some 10-15% of those with baseline significant disability had improved. The patterns of transitions between 12 and 36 months of follow-up were slightly different. The results indicated more deterioration (13-38%) and less improvement (6-9%). After controlling for baseline functional status, the best predictors for functional decline at 36 months were prior disability, functional limitations, cognitive impairment and comorbidity burden. We found that older adults' functional status may decline or improve even if the participants are disabled. Disabled conditions play a crucial role in the development of future disability and preventive actions need to be implemented.
本研究旨在探讨社区居住的残疾老年人功能状态随时间的变化。本研究探讨了功能状态下降的临床和社会人口统计学预测因素。对 SIPA 三年纵向研究的数据（n=1164）进行了分析。定义了三种功能状态类别：无重要残疾、有显著 IADL 残疾和有显著 ADL 残疾。在基线时，结果显示，这三种功能状态的患病率分别为 26.9%、58.6%和 14.5%。12 个月后，约有 50-60%的参与者保持在同一状态，而约有 10-15%基线有显著残疾的参与者有所改善。12 至 36 个月随访期间的转换模式略有不同。结果表明，更多的恶化（13-38%）和更少的改善（6-9%）。在控制基线功能状态后，36 个月时功能下降的最佳预测因素是先前的残疾、功能限制、认知障碍和合并症负担。我们发现，即使参与者残疾，老年人的功能状态也可能下降或改善。残疾状况在未来残疾的发展中起着至关重要的作用，需要采取预防措施。
