Hopkins Center for Health Disparities Solutions, Department of Health Policy and Management, The Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway Ste. 441, Baltimore, MD 21205, USA.
J Gerontol A Biol Sci Med Sci. 2011 Oct;66(10):1114-23. doi: 10.1093/gerona/glr102. Epub 2011 Jul 9.
This study examines the relationship between race and mobility over 5 years in initially well-functioning older adults and evaluates how a broad set of socioeconomic status indicators affect this relationship.
Data were from 2,969 black and white participants aged 70-79 from the Health, Aging, and Body Composition study. Mobility parameters included self-reported capacity to walk a quarter mile and climb 10 steps and usual gait speed. Incident mobility limitation was defined as reported difficulty walking a quarter mile or climbing 10 steps at two consecutive semiannual assessments. Gait speed decline was defined as a 4% reduction in speed per year.
At baseline, even though all participants were free of mobility limitation, blacks had slower walking speed than their white counterparts, which was not explained by poverty, education, reading level, or income adequacy. After 5 years, accounting for age, site, and baseline mobility, blacks were more likely to develop mobility limitation than whites. Adjusting for prevalent conditions at baseline eliminated this difference in women; controlling for education eliminated this difference in men. No differences in gait speed decline were identified.
Higher rates of mobility loss observed in older blacks relative to older whites appear to be a function of both poorer initial mobility status and existing health conditions particularly for women. Education may also play a role especially for men.
本研究考察了在最初功能良好的老年人中，种族与 5 年内移动能力的关系，并评估了一系列广泛的社会经济地位指标如何影响这种关系。
数据来自健康、衰老和身体组成研究中的 2969 名年龄在 70-79 岁的黑人和白人参与者。移动能力参数包括自我报告的行走四分之一英里和爬 10 级台阶的能力以及通常的步行速度。新发移动能力受限定义为连续两次半年评估时报告行走四分之一英里或爬 10 级台阶有困难。步行速度下降定义为每年速度降低 4%。
在基线时，尽管所有参与者都没有移动能力受限，但黑人的步行速度比白人慢，这不能用贫困、教育、阅读水平或收入充足程度来解释。5 年后，在考虑年龄、地点和基线移动能力的情况下，黑人比白人更容易出现移动能力受限。在女性中，调整基线时的现有疾病消除了这一差异；在男性中，控制教育消除了这一差异。在步行速度下降方面没有差异。
与老年白人相比，老年黑人移动能力丧失的比率较高，这似乎是初始移动能力较差和现有健康状况较差的共同作用，尤其是对女性而言。教育也可能起作用，尤其是对男性而言。
