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老年女性的下肢身体机能、自我报告的行动困难以及行动补偿策略的使用情况。

Lower extremity physical performance, self-reported mobility difficulty, and use of compensatory strategies for mobility by elderly women.

作者信息

Ganesh Shanti Portia, Fried Linda P, Taylor Donald H, Pieper Carl F, Hoenig Helen M

机构信息

Health Services Research and Development Service, Veterans Administration Medical Center, Hines, IL, USA.

出版信息

Arch Phys Med Rehabil. 2011 Feb;92(2):228-35. doi: 10.1016/j.apmr.2010.10.012.

Abstract

OBJECTIVE

To describe the relationship between lower extremity physical performance, self-reported mobility difficulty, and self-reported use of compensatory strategies (CSs) for mobility inside the home.

DESIGN

Cross-sectional exploratory study.

SETTING

Community-dwelling elders.

PARTICIPANTS

Disabled, cognitively intact women 65 years or older (N=1002), from the Women's Health and Aging Study I.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

CS scale: no CS, behavioral modifications (BMs) only, durable medical equipment (DME) with or without use of BMs, and any use of human help (HH); and 3 dichotomous CS measures: any CS (vs none); DME+HH (vs BMs only, among users of any CS); any HH (vs DME only, among users of any DME/HH).

RESULTS

Self-reported mobility difficulty and physical performance were significantly correlated with one another (r=-.57, P<.0001) and with the CS scale ([r=.51, P<.001] and [r=-.54, P<.0001], respectively). Sequential logistic regressions showed self-reported difficulty and physical performance were significant independent predictors of each category of CS. For the any CS and DME+HH models, the odds ratio for self-reported difficulty decreased by approximately 50% when physical performance was included in the model, compared with difficulty alone ([18.0 to 8.6] and [7.3 to 3.8], respectively), but both physical performance and difficulty remained significant predictors (P<.0001). The effects of covariates differed for the various CS categories, with some covariates having independent relationships to CS, and others appearing to have moderating or mediating effects on the relationship of self-reported difficulty or physical performance to CS.

CONCLUSIONS

Physical performance, self-reported difficulty, health conditions, and contextual factors have complex effects on the way elders carry out mobility inside the home.

摘要

目的

描述下肢身体机能、自我报告的活动困难以及自我报告的在家中活动时使用代偿策略(CSs)之间的关系。

设计

横断面探索性研究。

地点

社区居住的老年人。

参与者

来自女性健康与衰老研究I的65岁及以上的残疾、认知功能完好的女性(N = 1002)。

干预措施

不适用。

主要结局指标

CS量表:无CS、仅行为调整(BMs)、使用或未使用BMs的耐用医疗设备(DME)以及任何人力帮助(HH)的使用;以及3项二分法CS测量指标:任何CS(与无CS相比);DME + HH(与仅使用BMs相比,在使用任何CS的人群中);任何HH(与仅使用DME相比,在使用任何DME/HH的人群中)。

结果

自我报告的活动困难与身体机能显著相关(r = -0.57,P <.0001),且与CS量表也显著相关(分别为[r = 0.51,P <.001]和[r = -0.54,P <.0001])。序贯逻辑回归显示,自我报告的困难和身体机能是CS各分类的显著独立预测因素。对于任何CS和DME + HH模型,与仅考虑困难相比,当模型中纳入身体机能时,自我报告困难的优势比分别降低了约50%(分别从18.0降至8.6和从7.3降至3.8),但身体机能和困难仍然是显著的预测因素(P <.0001)。协变量对不同CS分类的影响不同,一些协变量与CS有独立关系,另一些协变量似乎对自我报告的困难或身体机能与CS之间的关系有调节或中介作用。

结论

身体机能、自我报告的困难、健康状况和环境因素对老年人在家中活动的方式有复杂影响。

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