生存意愿与老年人 10 年随访期间的生存情况。

Will-to-live and survival in a 10-year follow-up among older people.

机构信息

Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland.

出版信息

Age Ageing. 2012 Nov;41(6):789-94. doi: 10.1093/ageing/afs082. Epub 2012 Jul 4.

DOI:10.1093/ageing/afs082

PMID:22762904

Abstract

BACKGROUND

there is little research how older people's will-to-live predicts their survival.

OBJECTIVE

to investigate how many years home-dwelling older people wish to live and how this will-to-live predicts their survival.

METHODS

as a part of the Drugs and Evidence-Based Medicine in the Elderly (DEBATE) study, 400 home-dwelling individuals aged 75-90 were recruited into a cardiovascular prevention trial in Helsinki. In 2000, a questionnaire about the wishes of their remaining life was completed by 283 participants. Participants were inquired how many years they would still wish to live, and divided into three groups according to their response: group 1: wishes to live <5 years, group 2: 5-10 years, group 3: >10 years. Mortality was confirmed from central registers during a 10-year follow-up. The adjusted Cox proportional hazard model was used to determine how will-to-live predicted survival.

RESULTS

in group 1 wishing to live less than 5 years, the mean age and the Charlson comorbidity index were the highest, and subjective health the poorest. There were no differences between the groups in cognitive functioning or feeling depressed. Mortality was the highest (68.0%) among those wishing to live <5 years compared with those wishing to live 5-10 years (45.6%) or over 10 years (33.3%) (P < 0.001). With group 1 as referent (HR: 1.0) in the Cox proportional hazard model adjusting for age, gender, Charlson comorbidity index and depressive feelings, HR for mortality was 0.66 (95% CI: 0.45-0.95) (P = 0.027) and 0.47 (95% CI: 0.26-0.86) (P = 0.011) in groups 2 and 3, respectively.

CONCLUSION

the will-to-live was a strong predictor for survival among older people irrespective of age, gender and comorbidities.

摘要

背景

关于老年人的生存意愿如何预测他们的生存时间，相关研究较少。

目的

探讨有多少居家老年人希望自己还能活多少年，以及这种生存意愿如何预测他们的生存时间。

方法

作为“药物与老年人循证医学（DEBATE）”研究的一部分，招募了 400 名年龄在 75-90 岁之间的居家老年人参与赫尔辛基心血管预防试验。2000 年，283 名参与者完成了一份关于其剩余寿命愿望的问卷。参与者被问到他们还希望活多少年，并根据他们的回答分为三组：组 1：希望活不到 5 年；组 2：希望活 5-10 年；组 3：希望活 10 年以上。通过中央登记处，在 10 年的随访期间确认了死亡率。使用调整后的 Cox 比例风险模型来确定生存意愿如何预测生存。

结果

在希望活不到 5 年的组 1 中，平均年龄和 Charlson 合并症指数最高，主观健康状况最差。在认知功能或抑郁感方面，三组之间没有差异。与希望活 5-10 年（45.6%）或 10 年以上（33.3%）的人相比，希望活不到 5 年的人（68.0%）死亡率最高（P<0.001）。在 Cox 比例风险模型中，以组 1 为参照（HR：1.0），调整年龄、性别、Charlson 合并症指数和抑郁感后，组 2 的死亡风险 HR 为 0.66（95%CI：0.45-0.95）（P=0.027），组 3 的死亡风险 HR 为 0.47（95%CI：0.26-0.86）（P=0.011）。