Davis Jennifer C, Bryan Stirling, Best John R, Li Linda C, Hsu Chun Liang, Gomez Caitlin, Vertes Kelly A, Liu-Ambrose Teresa
Centre for Clinical Epidemiology and Evaluation, University of British Columbia and Vancouver Coastal Health Research Institute (VCHRI), 828 West 10th Avenue, Vancouver, BC, V6T 2B5, Canada.
Department of Physical Therapy, University of British Columbia, 2177 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.
Health Qual Life Outcomes. 2015 Jul 15;13:101. doi: 10.1186/s12955-015-0299-0.
Older adults with mobility impairments are prone to reduced health related quality of life (HRQoL) is highly associated with mobility impairments. The consequences of falls have detrimental impact on mobility. Hence, ascertaining factors explaining variation among individuals' quality of life is critical for promoting healthy ageing, particularly among older fallers. Hence, the primary objective of our study was to identify key factors that explain variation in HRQoL among community dwelling older adults at risk of falls.
We conducted a longitudinal analysis of a 12-month prospective cohort study at the Vancouver Falls Prevention Clinic (n = 148 to 286 depending on the analysis). We constructed linear mixed models where assessment month (0, 6, 12) was entered as a within-subjects repeated measure, the intercept was specified as a random effect, and predictors and covariates were entered as between-subjects fixed effects. We also included the predictors by sex and predictor by sex by time interaction terms in order to investigate sex differences in the relations between the predictor variable and the outcome variable, the EQ-5D.
Our primary analysis demonstrated a significant mobility (assessed using the Short Performance Physical Battery and the Timed Up and Go) by time interaction (p < 0.05) and mobility by time by sex interaction (p < 0.05). The sensitivity analyses demonstrated some heterogeneity of these findings using an imputed and a complete case analysis.
Mobility may be an important predictor of changes in HRQoL over time. As such, mobility is a critical factor to target for future intervention strategies aimed at maintaining or improving HRQoL in late life.
行动不便的老年人往往健康相关生活质量(HRQoL)下降,且HRQoL与行动不便高度相关。跌倒的后果对行动能力有不利影响。因此,确定个体生活质量差异的影响因素对于促进健康老龄化至关重要,尤其是在老年跌倒者中。因此,我们研究的主要目的是确定解释社区居住的有跌倒风险的老年人HRQoL差异的关键因素。
我们在温哥华跌倒预防诊所进行了一项为期12个月的前瞻性队列研究的纵向分析(根据分析,样本量n = 148至286)。我们构建了线性混合模型,将评估月份(0、6、12)作为受试者内重复测量因素输入,将截距指定为随机效应,将预测变量和协变量作为受试者间固定效应输入。我们还纳入了按性别划分的预测变量以及预测变量与时间的性别交互项,以研究预测变量与结果变量EQ-5D之间关系的性别差异。
我们的主要分析表明,在时间交互作用方面,行动能力(使用简短体能测试电池和计时起立行走测试评估)有显著差异(p < 0.05),在行动能力与时间的性别交互作用方面也有显著差异(p < 0.05)。敏感性分析表明,使用插补法和完整病例分析时,这些结果存在一些异质性。
行动能力可能是HRQoL随时间变化的重要预测因素。因此,行动能力是未来旨在维持或改善晚年HRQoL的干预策略的关键目标因素。