1999 - 2009年美国的中风与积极预期寿命

Stroke and active life expectancy in the United States, 1999-2009.

作者信息

Laditka James N, Laditka Sarah B

机构信息

Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA.

出版信息

Disabil Health J. 2014 Oct;7(4):472-7. doi: 10.1016/j.dhjo.2014.06.005. Epub 2014 Jul 1.

DOI:10.1016/j.dhjo.2014.06.005

PMID:25096630

Abstract

BACKGROUND

Stroke reduces active life expectancy, both years lived and their proportion without disability. However, active life expectancy studies have provided limited information about strokes in the United States, those occurring throughout older life, or those affecting African Americans.

OBJECTIVE

To measure associations between strokes throughout older life and active life expectancy for African American and White women and men.

METHODS

Using data from the Panel Study of Income Dynamics, 1999-2009 (n = 1862, 13,603 person-years), we estimated monthly probabilities of death and disability in activities of daily living with multinomial logistic Markov models adjusted for age, sex, ethnicity, stroke in the past two years, earlier stroke, and education. A random effect accounted for the panel data repeated measures. Microsimulation created large populations with stroke incidence throughout older life, identifying life expectancy and the proportions of remaining life with and without disability. We matched individuals with strokes with randomly selected persons without strokes by age at first stroke, sex, ethnicity, and previous disability.

RESULTS

Average age at first stroke was higher for women, lower for African Americans. African American and White women were disabled for about two-thirds of life after stroke; results for men were 61.8% for African Americans and 37.2% for Whites. Compared to matched participants, those with strokes lived 33% fewer remaining years (95% confidence interval, CI 30.9%-34.7%) with a 31.6% greater proportion of remaining life with disability (CI 14.4%-55.6%).

CONCLUSIONS

Stroke greatly reduces both life expectancy and the proportion of life without disability, particularly for women and African Americans.

摘要

背景

中风会降低积极预期寿命，包括存活年限以及无残疾存活年限的比例。然而，关于美国中风情况、老年期各阶段发生的中风或非裔美国人中风情况的积极预期寿命研究提供的信息有限。

目的

衡量老年期各阶段中风与非裔美国人和白人女性及男性的积极预期寿命之间的关联。

方法

利用1999 - 2009年收入动态面板研究的数据（n = 1862，13603人年），我们采用多项逻辑马尔可夫模型估计了日常生活活动中死亡和残疾的月度概率，并对年龄、性别、种族、过去两年内的中风、既往中风和教育程度进行了调整。随机效应考虑了面板数据的重复测量。微观模拟创建了老年期各阶段有中风发病率的大量人群，确定了预期寿命以及有残疾和无残疾的剩余寿命比例。我们根据首次中风时的年龄、性别、种族和既往残疾情况，将中风患者与随机选择的无中风者进行匹配。

结果

女性首次中风的平均年龄较高，非裔美国人较低。非裔美国人和白人女性中风后约三分之二的生命处于残疾状态；男性的结果是非裔美国人为61.8%，白人为37.2%。与匹配的参与者相比，中风患者的剩余存活年限减少了33%（95%置信区间，CI 30.9% - 34.7%），残疾剩余寿命比例增加了31.6%（CI 14.4% - 55.6%）。