Division of General Internal Medicine, Kyushu Dental College, Manazuru 2-6-1, Kokurakita-ku, Kitakyushu, 803-8580, Japan.
Aging Clin Exp Res. 2013 May;25(2):193-201. doi: 10.1007/s40520-013-0029-6. Epub 2013 Apr 3.
Although total mortality is likely to be higher in elderly individuals with frailty or impaired activities of daily living (ADL), little is known about the relationships between disease-specific mortality and ADL dependency in the elderly. Therefore, we examined whether 12-year disease-specific mortality may be associated with ADL dependency in an 80-year-old population.
In 1998, of 1,282 community-dwelling residents of Japan's Fukuoka Prefecture, 824 (64.3 %) (309 males and 515 females) participated, the remaining 458 subjects did not participate, and their deaths and causes of death were followed up for 12 years after the baseline examination. ADL dependency was determined according to the guidelines for disabled elderly from the Health, Labor, and Welfare Ministry of Japan, and ADL dependency was measured only at baseline.
During the 12-year follow-up, 506 died, 276 did not die, and 42 were lost. Of the 506 who died, 128 died due to cardiovascular disease, 96 to respiratory tract disease, 87 to cancer, and 51 to senility. The subjects were classified into three groups as follows: ADL-1 (independent group, n = 600), ADL-2 (almost-independent group, n = 113), and ADL-3 (dependent group, n = 93).Total-cause mortality was 2.8 times higher in ADL-3 subjects, respiratory disease mortality was 4.1 times higher in ADL-3 subjects, and senility mortality was 5.7 times higher in ADL-3 subjects than in ADL-1 subjects, after adjusting for various confounding factors. There was no association between mortality due to cancer or cardiovascular disease and ADL dependency.
We found an independent association between ADL dependency and mortality due to all causes, respiratory disease or senility, but no association with mortality due to cancer or cardiovascular disease. These findings suggest that improving ADL dependency may reduce all mortality and mortality due to respiratory disease or senility.
尽管虚弱或日常生活活动（ADL）受损的老年人总死亡率可能更高，但关于老年人特定疾病死亡率与 ADL 依赖之间的关系知之甚少。因此，我们研究了在 80 岁人群中，12 年特定疾病死亡率是否与 ADL 依赖相关。
1998 年，日本福冈县的 1282 名社区居民中，有 824 名（64.3%）（309 名男性和 515 名女性）参与了研究，其余 458 名未参与研究，他们的死亡和死因在基线检查后随访了 12 年。ADL 依赖根据日本厚生劳动省制定的残疾老年人指南确定，仅在基线时测量 ADL 依赖。
在 12 年的随访期间，506 人死亡，276 人未死亡，42 人失访。在 506 名死亡者中，128 人死于心血管疾病，96 人死于呼吸道疾病，87 人死于癌症，51 人死于衰老。受试者被分为三组：ADL-1（独立组，n=600）、ADL-2（几乎独立组，n=113）和 ADL-3（依赖组，n=93）。调整各种混杂因素后，ADL-3 组的全因死亡率是 ADL-1 组的 2.8 倍，ADL-3 组的呼吸道疾病死亡率是 ADL-1 组的 4.1 倍，ADL-3 组的衰老死亡率是 ADL-1 组的 5.7 倍。癌症或心血管疾病死亡率与 ADL 依赖无关。
我们发现 ADL 依赖与全因、呼吸道疾病或衰老导致的死亡率之间存在独立关联，但与癌症或心血管疾病导致的死亡率无关。这些发现表明，改善 ADL 依赖可能会降低全因死亡率和呼吸道疾病或衰老导致的死亡率。
