University of North Carolina School of Medicine, Chapel Hill, USA.
J Gerontol A Biol Sci Med Sci. 2011 May;66(5):577-81. doi: 10.1093/gerona/glr023. Epub 2011 Mar 7.
To examine the impact of educational attainment on the incidence of preclinical mobility disability (PCD).
The Women's Health and Aging II Study is a prospective observational cohort study of 436 initially high-functioning community-dwelling women aged 70-79 years at baseline in Baltimore, Maryland. We measured the association of highest attained education level with preclinical mobility disability (PCD) over an 11-year period. PCD is defined as self-reported modification in any of four tasks without reporting difficulty in those tasks. The tasks were walking ½ mile, climbing up steps, doing heavy housework, and getting in/out of bed or chair.
Participants with less than 9 years of education were more likely to acquire incident PCD (hazard ratio: 3.1, 95% confidence interval = 1.2-7.7) than their counterparts with more education after adjusting for income, marital status, number of diseases, and high self-efficacy.
Lower education level is an independent predictor of incident preclinical mobility disability. This association has important implications for primary and secondary prevention and can be easily assessed in clinical encounters.
本研究旨在探讨教育程度对临床前期失能（PCD）发生率的影响。
妇女健康和老龄化研究 II 是一项前瞻性观察队列研究，纳入了马里兰州巴尔的摩市 436 名基线时年龄为 70-79 岁、功能较高的社区居住女性。我们在 11 年的时间内，评估了最高受教育程度与临床前期失能（PCD）之间的相关性。PCD 定义为自我报告的四项任务中的任何一项发生改变，而在这些任务中报告没有困难。这四项任务包括行走半英里、爬楼梯、做繁重的家务和上下床或椅子。
与受教育程度较高者相比，受教育程度不足 9 年的参与者更易发生新发 PCD（风险比：3.1，95%置信区间=1.2-7.7），但在调整收入、婚姻状况、疾病数量和高自我效能感后，差异无统计学意义。
较低的教育程度是临床前期失能的独立预测因子。这一关联对一级和二级预防具有重要意义，且可在临床就诊时轻松评估。
