Chen Yiqun, Sloan Frank A
Economics, Duke University, Durham, NC.
Health Serv Res. 2015 Oct;50(5):1528-49. doi: 10.1111/1475-6773.12284. Epub 2015 Feb 6.
To examine disability trends among U.S. near-elderly and elderly persons and explain observed trends.
1996-2010 waves of the Health and Retirement Study.
We first examined trends in Activities of Daily Living and Instrumental Activities of Daily Living limitations, and large muscle, mobility, gross motor, and fine motor indexes. Then we used decomposition analysis to estimate contributions of changes in sociodemographic composition, self-reported chronic disease prevalence and health behaviors, and changes in disabling effects of these factors to disability changes between 1996 and 2010.
Disability generally increased or was unchanged. Increased trends were more apparent for near-elderly than elderly persons. Sociodemographic shifts tended to reduce disability, but their favorable effects were largely offset by increased self-reported chronic disease prevalence. Changes in smoking and heavy drinking prevalence had relatively minor effects on disability trends. Increased obesity rates generated sizable effects on lower-body functioning changes. Disabling effects of self-reported chronic diseases often declined, and educational attainment became a stronger influence in preventing disability.
Such unfavorable trends as increased chronic disease prevalence and higher obesity rates offset or outweighed the favorable effects with the result that disability remained unchanged or increased.
研究美国接近老年和老年人群的残疾趋势，并解释观察到的趋势。
1996 - 2010年健康与退休研究的各轮调查。
我们首先研究了日常生活活动和工具性日常生活活动受限情况的趋势，以及大肌肉、 mobility、总体运动和精细运动指标。然后我们使用分解分析来估计社会人口构成变化、自我报告的慢性病患病率和健康行为变化，以及这些因素的致残效应变化对1996年至2010年期间残疾变化的贡献。
残疾总体上有所增加或保持不变。接近老年人群的增加趋势比老年人群更明显。社会人口结构变化往往会减少残疾，但它们的有利影响在很大程度上被自我报告的慢性病患病率上升所抵消。吸烟和重度饮酒患病率的变化对残疾趋势的影响相对较小。肥胖率上升对下肢功能变化产生了相当大的影响。自我报告的慢性病的致残效应往往下降，而教育程度在预防残疾方面的影响变得更强。
慢性病患病率上升和肥胖率上升等不利趋势抵消或超过了有利影响，结果残疾状况保持不变或增加。
