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外出频率低和社交孤立对功能衰退的协同或独立影响:对日本城市老年人的4年前瞻性研究。

Synergistic or independent impacts of low frequency of going outside the home and social isolation on functional decline: A 4-year prospective study of urban Japanese older adults.

作者信息

Fujiwara Yoshinori, Nishi Mariko, Fukaya Taro, Hasebe Masami, Nonaka Kumiko, Koike Takashi, Suzuki Hiroyuki, Murayama Yoh, Saito Masashige, Kobayashi Erika

机构信息

Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.

Sei-Gakuin University, Saitama, Japan.

出版信息

Geriatr Gerontol Int. 2017 Mar;17(3):500-508. doi: 10.1111/ggi.12731. Epub 2016 Jan 22.

Abstract

AIM

Decreased frequency of going outside the home and being socially isolated are regarded as predictors of poor health. The object of the present study was to clarify whether these factors have synergistic or independent impacts on future functional decline.

METHODS

We examined a prospective cohort of 2427 community-dwelling persons, aged ≥65 years, who responded to the baseline mail survey in Wako City, in 2008. Participants were asked about the frequency of going outside the home, social isolation status (having contact less than once a week with anyone outside household), functional capacity (Tokyo Metropolitan Institute of Gerontology-Index of Competence), age, sex, annual income, self-rated health, depressive mood and mobility.

RESULTS

Of 1575 persons (72.1%) who completely responded to the follow-up survey (T2) in 2012, we defined the groups as follows: group 1, not isolated and going outside the home every day (n = 897); group 2, not isolated and going outside the home less than every day (n = 311); group 3, isolated and going outside the home every day (n = 224); and group 4, isolated and going outside the home less than every day (n = 143). Multiple logistic regression analyses showed that the variables identifying group 3 for men and group 2 for women with reference to group 1 were predictors of subsequent functional decline even after adjustment for confounders (odds ratios 2.01, 1.63; 95% CI 1.20-3.38, 1.03-2.56, respectively).

CONCLUSION

Social isolation regardless of going outside the home every day for men and going outside the home less than every day regardless of being not socially isolated for women might predict functional decline. Geriatr Gerontol Int 2017; 17: 500-508.

摘要

目的

外出频率降低和社交孤立被视为健康状况不佳的预测因素。本研究的目的是阐明这些因素对未来功能衰退是具有协同作用还是独立影响。

方法

我们对2008年在和光市回应基线邮件调查的2427名年龄≥65岁的社区居住者进行了前瞻性队列研究。参与者被问及外出频率、社交孤立状况(与家庭以外的任何人每周接触少于一次)、功能能力(东京都老人综合研究所能力指数)、年龄、性别、年收入、自评健康状况、抑郁情绪和活动能力。

结果

在2012年对随访调查(T2)做出完整回应的1575人(72.1%)中,我们将研究对象分为以下几组:第1组,非孤立且每天外出(n = 897);第2组,非孤立且并非每天外出(n = 311);第3组,孤立且每天外出(n = 224);第4组,孤立且并非每天外出(n = 143)。多因素logistic回归分析显示,以第1组为参照,确定男性为第3组和女性为第2组的变量即使在对混杂因素进行调整后仍是后续功能衰退的预测因素(优势比分别为2.01、1.63;95%置信区间分别为1.20 - 3.38、1.03 - 2.56)。

结论

对于男性而言,无论是否每天外出,社交孤立都可能预示功能衰退;对于女性而言,无论是否社交孤立,并非每天外出都可能预示功能衰退。《老年医学与老年病学国际杂志》2017年;17:500 - 508。

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