美国老年残疾趋势：探索年龄、时期和队列效应。
Trends in US older adult disability: exploring age, period, and cohort effects.
机构信息
Center for Health Equity Research and Policy, San Diego State University, 9245 Sky Park Court, Suite 100, San Diego, CA 92123, USA.
出版信息
Am J Public Health. 2012 Nov;102(11):2157-63. doi: 10.2105/AJPH.2011.300602. Epub 2012 Sep 20.
OBJECTIVES
We elucidated how US late-life disability prevalence has changed over the past 3 decades.
METHODS
We examined activities of daily living (ADL) and instrumental activities of daily living (IADL) disability trends by using age-period-cohort (APC) models among older adults aged 70 years or older who responded to the National Health Interview Survey between 1982 and 2009. We fitted logistic regressions for ADL and IADL disabilities and for each of the 3 APC trends with 2 models: unadjusted and fully adjusted for age, period, cohort, and sociodemographic variables.
RESULTS
The unadjusted and adjusted period trends showed a substantial decline in IADL disability, and ADL disability remained stable across time. Unadjusted cohort trends for both outcomes also showed continual declines across successive cohorts; however, increasing cohort trends were evident in the adjusted models.
CONCLUSIONS
More recent cohorts of US older adults are becoming more disabled, net of aging and period effects. The net upward cohort trends in ADL and IADL disabilities remain unexplained. Further studies should explore cohort-specific determinants contributing to the increase of cohort-based disability among US older adults.
目的
我们旨在阐明美国老年人生活功能障碍的患病率在过去 30 年中是如何变化的。
方法
我们通过使用年龄-时期-队列（APC）模型，研究了 1982 年至 2009 年期间参加国家健康访谈调查的 70 岁及以上老年人的日常生活活动（ADL）和工具性日常生活活动（IADL）的残疾趋势。我们使用 2 种模型（未调整和完全调整年龄、时期、队列和社会人口统计学变量）对 ADL 和 IADL 残疾以及 3 种 APC 趋势中的每一种进行了逻辑回归分析。
结果
未调整和调整后的时期趋势显示 IADL 残疾显著下降，而 ADL 残疾在整个研究期间保持稳定。未调整的队列趋势也显示两种结果都在持续下降，但调整后的模型显示出递增的队列趋势。
结论
美国较年轻的老年人队列的残疾程度在不断增加，这与老龄化和时期效应无关。ADL 和 IADL 残疾的净上升队列趋势仍未得到解释。进一步的研究应该探索导致美国老年人基于队列的残疾增加的特定队列决定因素。
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