Myers-JDC-Brookdale Institute, Aging Department, Jerusalem, Israel.
Gerontologist. 2014 Dec;54(6):919-29. doi: 10.1093/geront/gnt084. Epub 2013 Aug 22.
The current study depicts improvement and decline in functioning among 3 population groups of Israeli older adults: Jews and veteran immigrants, former Soviet Union immigrants, and Arabs.
Using longitudinal data from 2005 and 2010 Survey of Health and Retirement (SHARE) in Israel (n = 982), we examined 4 functional changes in late life in mobility, movement, activities of daily living (ADL), and instrumental ADL, as a function of sociodemographic, health, and social variables
The findings reveal that physical functioning among older adults can decline as well as improve over time. Older age, higher number of diseases and comorbidity, living with others (not the spouse) compared with living alone, receiving informal help and formal help with homemaking, and declined mental health and cognitive status predict deterioration in physical functioning. Also, Arab older adults are at higher risk of deterioration over time compared with Jewish older adults.
Findings imply that noncompatible assistance to older adults may "save them the hassle" of doing things by themselves and thus, weakens a potential functional rehabilitation process. There is a need to guide not only professional personnel but also nonprofessional home care workers and family members on how to encourage and retain older adults' functions as much as possible in order to improve their quality of life. Another implication of investing in rehabilitation is that it might reduce the disability rate among older adults and thus save health expenditures on long-term care at the macrosocial level.
本研究描述了以色列 3 个人群组的老年成年人在功能方面的改善和下降情况:犹太人及退伍移民、前苏联移民和阿拉伯人。
利用以色列 2005 年和 2010 年健康与退休调查(SHARE)的纵向数据(n=982),我们考察了晚年在移动、活动、日常生活活动(ADL)和工具性 ADL 方面的 4 项功能变化,这是社会人口统计学、健康和社会变量的函数。
研究结果表明,老年人的身体功能可能会随着时间的推移而下降,也可能会改善。年龄较大、患有更多疾病和合并症、与他人(而非配偶)同住、接受非正式帮助和家务方面的正式帮助、心理健康和认知状态下降,这些因素都预示着身体功能的恶化。此外,与犹太老年人相比,阿拉伯老年成年人随着时间的推移,功能恶化的风险更高。
研究结果意味着,为老年人提供不兼容的帮助可能会“省去他们自己动手的麻烦”,从而削弱了潜在的功能康复过程。不仅需要指导专业人员,还需要指导非专业的家庭护理人员和家庭成员如何尽可能地鼓励和保留老年人的功能,以提高他们的生活质量。投资康复的另一个意义是,它可能会降低老年人的残疾率,从而节省宏观社会层面上长期护理的医疗支出。