Center for State Health Policy, Rutgers University, New Brunswick, New Jersey, USA.
J Gerontol B Psychol Sci Soc Sci. 2010 Nov;65(6):715-9. doi: 10.1093/geronb/gbp115. Epub 2009 Dec 22.
We evaluated the longitudinal association between self-rated health (SRH) and timed gait, an indicator of lower extremity dysfunction, in a community-based sample of older persons.
Participants (N = 754) were evaluated at 18-month intervals for 72 months. SRH was categorized as Excellent/Very Good/Good and Fair/Poor. Participants were asked to walk a 10-foot course "as fast as it feels safe and comfortable," turn around, and walk back, with timed gait defined as normal (≤10 s) or slow (>10 s). Generalized multinomial logit models, adjusted for demographic features, biomedical and psychosocial factors, and activities of daily living, evaluated the association between SRH and the likelihood of 6 possible transitions (from normal or slow timed gait to normal timed gait, slow timed gait, or death) over time. We also ran a repeated measures linear mixed model with change in timed gait as the outcome.
Compared with participants reporting Excellent/Very Good/Good SRH, those reporting Fair/Poor SRH were more likely to transition from normal to slow timed gait or to death. SRH was not associated with transitions from slow timed gait to normal timed gait or to death. In addition, time to complete the gait task increased (i.e., slowed) over time among participants reporting Fair/Poor SRH compared with those reporting Excellent/Very Good/Good SRH.
Among older persons, SRH is associated with the development of lower extremity dysfunction but not with recovery from lower extremity dysfunction. This relationship may indicate an intermediate step in the pathway from SRH to mortality.
我们评估了自我报告的健康状况（SRH）与计时步态（下肢功能障碍的指标）在社区老年人样本中的纵向关联。
参与者（N=754）在72个月内每18个月评估一次。SRH 分为优秀/非常好/好和一般/差。要求参与者在 10 英尺的路程上“尽可能安全和舒适地走”，然后转身走回来，计时步态定义为正常（≤10 秒）或缓慢（>10 秒）。广义多项逻辑回归模型，调整了人口统计学特征、生物医学和心理社会因素以及日常生活活动，评估了 SRH 与以下 6 种可能的过渡之间的关联（从正常或缓慢的计时步态到正常的计时步态、缓慢的计时步态或死亡）。我们还运行了一个重复测量线性混合模型，以计时步态的变化为结果。
与报告优秀/非常好/好的 SRH 的参与者相比，报告一般/差的 SRH 的参与者更有可能从正常过渡到缓慢的计时步态或死亡。SRH 与从缓慢的计时步态到正常的计时步态或死亡的过渡无关。此外，与报告优秀/非常好/好的 SRH 的参与者相比，报告一般/差的 SRH 的参与者完成步态任务的时间（即变慢）随着时间的推移而增加。
在老年人中，SRH 与下肢功能障碍的发展有关，但与下肢功能障碍的恢复无关。这种关系可能表明 SRH 与死亡率之间的路径中的一个中间步骤。
