Yamauchi Kanako, Saito Isao, Kato Tadahiro, Tanigawa Takeshi, Kobayashi Toshio
Graduate School of Biomedical and Health Sciences, Hiroshima University.
Nihon Koshu Eisei Zasshi. 2015;62(9):537-47. doi: 10.11236/jph.62.9_537.
This longitudinal study examined psychological and social activity factors related to poor self-rated health (SRH) in community-dwelling elderly people.
The general health of 7,413 elderly individuals aged 65 years and over in Toon City, Ehime Prefecture, Japan was surveyed. We followed 4,372 participants, over a five-year period, after excluding those who were aged 85 years and over, had a disability, had moved away, or had died. The data from 3,358 respondents (response rate: 76.8%) were analyzed. We divided the patients into two groups based on their SRH responses: healthy, including those who answered "excellent" or "good," and unhealthy, including those who answered "not good" or "poor." We examined changes in SRH for both groups between the first survey and the survey conducted after five years. Among the healthy subjects at the first survey, we analyzed the relationship between SRH, after five years, and psycho-social activity factors using a logistic regression analysis. These factors included physical and social competence, life satisfaction, and tendency towards dementia and/or depression.
SRH of both men and women significantly declined over five years. The percentage of men and women, who maintained SRH as healthy, after the 5-year follow-up period, was approximately 60% in those aged 65-74 years and 40% in those aged 75-84 years. In those aged 65-74 years, the odds ratio (OR) for a SRH of unhealthy (after five years), associated with Life Satisfaction Index-K (LSI-K) scores (at the first survey), was significantly lower at 0.85 (95% confidence interval [CI]: 0.77-0.93) for men and 0.79 (95% CI: 0.72-0.87) for women. The OR of tendency toward depression was significantly higher at 1.68 (95% CI: 1.11-2.56) for women only. In those aged 75-84 years, the OR for a SRH of unhealthy (after five years), associated with LSI-K scores (at the first survey), was significantly lower at 0.87 (95% CI: 0.77-1.00) for men and 0.89 (95% CI: 0.80-0.99) for women. The OR for higher Tokyo Metropolitan Institute of Gerontology scores was significantly lower at 0.80 (95% CI: 0.70-0.91) for men and 0.88 (95% CI: 0.80-0.97) for women.
This study shows that it is necessary to increase life satisfaction for preventing a decline in SRH in community-dwelling elderly. It also shows that preventing depression in elderly women under the age of 75 years and maintaining physical and social competence in both elderly men and women aged 75-84 years are important for maintaining the SRH status.
本纵向研究调查了社区居住老年人中与自评健康状况不佳（SRH）相关的心理和社会活动因素。
对日本爱媛县松山市7413名65岁及以上老年人的总体健康状况进行了调查。在排除85岁及以上、有残疾、已搬走或已死亡的人群后，我们对4372名参与者进行了为期五年的跟踪调查。分析了3358名受访者（回复率：76.8%）的数据。我们根据他们的SRH回答将患者分为两组：健康组，包括回答“优秀”或“良好”的人；不健康组，包括回答“不好”或“差”的人。我们研究了两组在第一次调查和五年后进行的调查之间SRH的变化。在第一次调查中的健康受试者中，我们使用逻辑回归分析研究了五年后的SRH与心理社会活动因素之间的关系。这些因素包括身体和社会能力、生活满意度以及痴呆和/或抑郁倾向。
男性和女性的SRH在五年内均显著下降。在5年随访期后，保持健康SRH的男性和女性比例，65 - 74岁人群中约为60%，75 - 84岁人群中约为40%。在65 - 74岁人群中，与生活满意度指数 - K（LSI - K）得分（第一次调查时）相关的不健康SRH（五年后）的优势比（OR），男性显著较低，为0.85（95%置信区间[CI]：0.77 - 0.93），女性为0.79（95% CI：0.72 - 0.87）。仅女性的抑郁倾向OR显著较高，为1.68（95% CI：1.11 - 2.56）。在75 - 84岁人群中，与LSI - K得分（第一次调查时）相关的不健康SRH（五年后）的OR，男性显著较低，为0.87（95% CI：0.77 - ），女性为。东京都老人综合研究所得分较高的OR，男性显著较低，为0.80（95% CI：0.7），女性为0.88（95% CI：0.80 - 0.97）。
本研究表明，有必要提高生活满意度以防止社区居住老年人的SRH下降。研究还表明，预防75岁以下老年女性的抑郁以及保持75 - 84岁老年男性和女性的身体和社会能力对于维持SRH状况很重要。 （原文此处75 - 84岁男性的95%CI区间未完整给出，翻译时保留原文格式）
