他汀类药物的使用与社区居住老年人步速下降
Statin use and decline in gait speed in community-dwelling older adults.
作者信息
Lo-Ciganic Wei-Hsuan, Perera Subashan, Gray Shelly L, Boudreau Robert M, Zgibor Janice C, Strotmeyer Elsa S, Donohue Julie M, Bunker Clareann H, Newman Anne B, Simonsick Eleanor M, Bauer Douglas C, Satterfield Suzanne, Caserotti Paolo, Harris Tamara, Shorr Ronald I, Hanlon Joseph T
机构信息
Center for Pharmaceutical Policy and Prescribing, Health Policy Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.
出版信息
J Am Geriatr Soc. 2015 Jan;63(1):124-9. doi: 10.1111/jgs.13134. Epub 2014 Dec 23.
OBJECTIVES
To examine the association between statin use and objectively assessed decline in gait speed in community-dwelling older adults.
DESIGN
Longitudinal cohort study.
SETTING
Health, Aging and Body Composition (Health ABC) Study.
PARTICIPANTS
Two thousand five participants aged 70-79 at baseline with medication and gait speed data at 1998-99, 1999-2000, 2001-02, and 2002-03.
MEASUREMENTS
The independent variables were any statin use and their standardized daily doses (low, moderate, high) and lipophilicity. The primary outcome measure was decline in gait speed of 0.1 m/s or more in the following year of statin use. Multivariable generalized estimating equations were used, adjusting for demographic characteristics, health-related behaviors, health status, and access to health care.
RESULTS
Statin use increased from 16.2% in 1998-99 to 25.6% in 2002-03. The overall proportions of those with decline in gait speed of 0.1 m/s or more increased from 22.2% in 1998 to 23.9% in 2003. Statin use was not associated with decline in gait speed of 0.1 m/s or more (adjusted odds ratio (AOR) = 0.90, 95% confidence interval (CI) = 0.77-1.06). Similar nonsignificant trends were also seen with the use of hydrophilic or lipophilic statins. Users of low-dose statins were found to have a 22% lower risk of decline in gait speed than nonusers (AOR = 0.78, 95% CI = 0.61-0.99), which was mainly driven by the results from 1999-2000 follow-up.
CONCLUSION
These results suggest that statin use did not increase decline in gait speed in community-dwelling older adults.
目的
研究在社区居住的老年人中，他汀类药物的使用与客观评估的步态速度下降之间的关联。
设计
纵向队列研究。
背景
健康、衰老与身体成分（Health ABC）研究。
参与者
2500名基线年龄为70 - 79岁的参与者，他们在1998 - 1999年、1999 - 2000年、2001 - 2002年和2002 - 2003年有用药及步态速度数据。
测量
自变量为是否使用任何他汀类药物及其标准化每日剂量（低、中、高）和亲脂性。主要结局指标是在使用他汀类药物后的下一年步态速度下降0.1米/秒或更多。使用多变量广义估计方程，对人口统计学特征、健康相关行为、健康状况和获得医疗保健的机会进行了调整。
结果
他汀类药物的使用从1998 - 1999年的16.2%增加到2002 - 2003年的25.6%。步态速度下降0.1米/秒或更多的总体比例从1998年的22.2%增加到2003年的23.9%。他汀类药物的使用与步态速度下降0.1米/秒或更多无关（调整后的优势比（AOR）= 0.90，95%置信区间（CI）= 0.77 - 1.06）。在使用亲水性或亲脂性他汀类药物时也观察到类似的无显著趋势。发现低剂量他汀类药物使用者步态速度下降的风险比未使用者低22%（AOR = 0.78，95% CI = 0.61 - 0.99），这主要是由1999 - 2000年随访结果驱动的。
结论
这些结果表明，在社区居住的老年人中，使用他汀类药物不会增加步态速度的下降。
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