Kuroiwa Yumi, Miyano Ichiro, Nishinaga Masanori, Takata Jun, Shimizu Yuji, Okumiya Kiyohito, Matsubayashi Kozo, Ozawa Toshio, Kitaoka Hiroaki, Doi Yoshinori, Yasuda Nobufumi
Department of Public Health, Kochi Medical School, Nankoku, Japan.
Department of Internal Medicine, Saitama Memorial Hospital, Saitama, Japan.
Geriatr Gerontol Int. 2015 Jul;15(7):840-7. doi: 10.1111/ggi.12356. Epub 2014 Nov 19.
The purpose of the present study was to clarify the longitudinal association between brachial-ankle pulse wave velocity (baPWV) and the onset of impairment in activities of daily living (ADL) among community-dwelling individuals.
Deaths and the onsets of ADL impairment during 3 years were followed for 450 individuals without ADL impairment at entry who were aged 65 years or older (men : women 181:269; mean age 77 years). They were dichotomized on the median baPWV value at entry.
Within 3 years, 28 died and 60 had an onset of ADL impairment. The high baPWV group had a higher incidence of deaths (high baPWV group vs low baPWV group, 9.3% vs 3.1%) and ADL impairment (high baPWV group vs low baPWV group, 20.7% vs 9.3%). After adjustment for age, sex and systolic blood pressure, as compared with the low baPWV group, the high baPWV group had increased risk for mortality (adjusted odds ratio 3.22; 95% confidence interval 1.26-8.22) and the onset of ADL impairment (adjusted odds ratio 1.94; 95% confidence interval 1.03-3.63). When the onset of ADL impairment was grouped according to medical conditions that preceded/accompanied the onset of ADL impairment, elevated baPWV was associated with increased risk for the onset of ADL impairment after/accompanying fall/fracture.
The assessment of arterial stiffness by baPWV contributes to identifying functionally independent community-dwelling older individuals at risk for ADL impairment, in particular ADL impairment associated with fall/fracture, as well as for mortality. Geriatr Gerontol Int 2015; 15: 840-847.
本研究旨在阐明社区居住个体的臂踝脉搏波速度（baPWV）与日常生活活动能力（ADL）受损发作之间的纵向关联。
对450名年龄在65岁及以上、入组时无ADL受损的个体（男性∶女性为181∶269；平均年龄77岁）进行了为期3年的随访，观察其死亡情况及ADL受损发作情况。根据入组时的baPWV中位数将他们分为两组。
在3年内，28人死亡，60人出现ADL受损发作。高baPWV组的死亡发生率（高baPWV组与低baPWV组，9.3%对3.1%）和ADL受损发生率（高baPWV组与低baPWV组，20.7%对9.3%）更高。在对年龄、性别和收缩压进行调整后，与低baPWV组相比，高baPWV组的死亡风险增加（调整后的优势比为3.22；95%置信区间为1.26 - 8.22），ADL受损发作风险增加（调整后的优势比为1.94；95%置信区间为1.03 - 3.63）。当根据ADL受损发作之前/伴随的医疗状况对ADL受损发作进行分组时，baPWV升高与跌倒/骨折后/伴随跌倒/骨折出现的ADL受损发作风险增加相关。
通过baPWV评估动脉僵硬度有助于识别功能独立的社区居住老年人中存在ADL受损风险的个体，特别是与跌倒/骨折相关的ADL受损以及死亡风险。《老年医学与老年病学国际杂志》2015年；15：840 - 847。
