老年人在 10 多年间的多次住宅迁移。
Residential relocations among older people over the course of more than 10 years.
机构信息
Department of Internal Medicine, Yale University School of Medicine, New Haven, CT; Department of Internal Medicine, Section of Geriatric Medicine, University of Amsterdam, Amsterdam, The Netherlands.
Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.
出版信息
J Am Med Dir Assoc. 2014 Jul;15(7):521-526. doi: 10.1016/j.jamda.2014.03.013. Epub 2014 May 1.
OBJECTIVE
The objective of this study was to describe the rates of residential relocations over the course of 10.5 years and evaluate differences in these relocation rates according to gender and decedent status.
DESIGN
Prospective, longitudinal study with monthly telephone follow-up for up to 126 months.
SETTING
Greater New Haven, CT.
PARTICIPANTS
There were 754 participants, aged 70 years or older, who were initially community-living and nondisabled in their basic activities of daily living.
MEASUREMENTS
Residential location was assessed during monthly interviews and included community, assisted living facility, and nursing home. A residential relocation was defined as a change of residential location for at least 1 week and included relocations within (eg, community-community) or between (community- assisted living) locations. We calculated the rates of relocations per 1000 patient-months and evaluated differences by gender and decedent status.
RESULTS
Sixty-six percent of participants had at least one residential relocation (range 0-12). Women had lower rates of relocations from nursing home to community (rate ratio [RR] 0.59, P = .02); otherwise, there were no gender differences. Decedents had higher rates of relocation from community to assisted living (RR 1.71, P = .002), from community to nursing home (RR 3.64, P < .001), between assisted living facilities (RR 3.65, P < .001), and from assisted living to nursing home (RR 2.5, P < .001). In decedents, relocations from community to nursing home (RR 3.58, P < .001) and from assisted living to nursing home (RR 3.3, P < .001) were most often observed in the last year of life.
CONCLUSIONS
Most older people relocated at least once during 10.5 years of follow-up. Women had lower rates of relocation from nursing home to community. Decedents were more likely to relocate to a residential location providing a higher level of assistance, compared with nondecedents. Residential relocations were most common in the last year of life.
目的
本研究旨在描述在 10.5 年的过程中居住迁移的比率，并根据性别和死者状况评估这些迁移率的差异。
设计
前瞻性、纵向研究，每月进行电话随访，最长可达 126 个月。
地点
康涅狄格州大纽黑文。
参与者
共有 754 名参与者，年龄在 70 岁或以上，他们最初在日常生活活动中具有社区生活能力且无残疾。
测量
每月访谈时评估居住地点，包括社区、辅助生活设施和养老院。居住迁移定义为居住地点至少改变 1 周，包括在（例如，社区-社区）或在（社区-辅助生活）之间的迁移。我们计算了每 1000 个患者月的迁移率，并根据性别和死者状况评估了差异。
结果
66%的参与者至少有一次居住迁移（范围 0-12）。女性从养老院到社区的迁移率较低（比率比[RR]0.59，P=0.02）；否则，没有性别差异。死者从社区到辅助生活设施的迁移率更高（RR 1.71，P=0.002），从社区到养老院的迁移率更高（RR 3.64，P<.001），从辅助生活设施到辅助生活设施的迁移率更高（RR 3.65，P<.001），从辅助生活设施到养老院的迁移率更高（RR 2.5，P<.001）。在死者中，从社区到养老院的迁移（RR 3.58，P<.001）和从辅助生活设施到养老院的迁移（RR 3.3，P<.001）最常发生在生命的最后一年。
结论
在 10.5 年的随访期间，大多数老年人至少迁移了一次。女性从养老院到社区的迁移率较低。与非死者相比，死者更有可能迁移到提供更高水平援助的居住地点。居住迁移在生命的最后一年最为常见。
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