Hajek André, König Hans-Helmut
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
PLoS One. 2016 Jan 19;11(1):e0146967. doi: 10.1371/journal.pone.0146967. eCollection 2016.
To examine time-dependent predictors of functional impairment in older adults in Europe longitudinally.
Data were derived from the Survey of Health Ageing, and Retirement in Europe (2004-2013). Functional impairment was assessed by using activities of daily living (ADL) and instrumental activities of daily living (IADL) indices. Fixed effects regressions were used to estimate the effects of sociodemographic factors (age, marital status, living situation, and income deciles (median split)), lifestyle factors (smoking status and alcohol consumption per week), depression, cognitive function and chronic diseases on the outcome variables.
Longitudinal regressions revealed that functional impairment increased significantly with age, the occurrence of depression, cognitive impairment, the number of chronic conditions, and less than daily alcohol consumption in the total sample and in both sexes. Moreover, the onset of smoking and living without a spouse/partner in household increased functional impairment in the total sample. The effect of depression on functional impairment was significantly more pronounced in men.
Our findings highlight the relevance of changes in age, depression, cognitive function, smoking and chronic diseases for functional impairment. Since particularly depression and smoking may be avoidable, developing strategies to prevent depression or stop smoking might be useful approaches to postpone functional impairment in older adults.
纵向研究欧洲老年人功能障碍的时间依赖性预测因素。
数据来源于欧洲健康、老龄化与退休调查（2004 - 2013年）。使用日常生活活动（ADL）和工具性日常生活活动（IADL）指数评估功能障碍。采用固定效应回归来估计社会人口学因素（年龄、婚姻状况、居住情况和收入十分位数（中位数划分））、生活方式因素（吸烟状况和每周饮酒量）、抑郁、认知功能和慢性病对结果变量的影响。
纵向回归显示，在总样本和男女两性中，功能障碍随年龄增长、抑郁的发生、认知障碍、慢性病数量以及每周饮酒少于每日饮酒量而显著增加。此外，吸烟的开始以及家中无配偶/伴侣生活在总样本中会增加功能障碍。抑郁对功能障碍的影响在男性中更为明显。
我们的研究结果强调了年龄、抑郁、认知功能、吸烟和慢性病变化与功能障碍的相关性。由于尤其是抑郁和吸烟可能是可避免的，制定预防抑郁或戒烟的策略可能是延缓老年人功能障碍的有用方法。
