Verbrugge Lois M, Brown Dustin C, Zajacova Anna
Population Studies Center, University of Michigan, Ann Arbor.
Department of Sociology and Social Science Research Center, Mississippi State University.
J Gerontol B Psychol Sci Soc Sci. 2017 Jan;72(1):151-161. doi: 10.1093/geronb/gbw002. Epub 2016 Mar 11.
We study changes in average disability over nearly two decades for a large epidemiological cohort of older Americans. As some people exit by mortality, do average disability levels for the living cohort rise rapidly, rise gradually, stay steady, or decline?
Data are from the Study of Asset and Health Dynamics Among the Oldest Old (AHEAD) cohort for 1993-2010. Cohort members are aged 70+ in 1993 (mean = 77.5 years), and the survivors are aged 87+ in 2010 (mean = 90.2 years). Personal care disability (activities of daily living), household management disability (instrumental activities of daily living), and physical limitations are studied. We study average disability for the living cohort over time and the disability histories for decedent and survivor groups.
Average disability rises gradually over time for the living cohort. Earlier decedent groups have higher average disability than later ones. Near death, disability rises sharply for all decedent groups. Longer surviving groups have less average disability, and slower disability increases, than shorter surviving groups. All results are repeated for younger cohort members (baseline age = 70-79 years), older ones (baseline age = 80+ years), women, and men.
As a cohort ages, average disability among living members increases gradually, signaling behavioral, psychological, and biological fitness in very old persons.
我们研究了一大群美国老年流行病学队列近二十年来平均残疾状况的变化。随着一些人因死亡退出队列，在世队列的平均残疾水平是迅速上升、逐渐上升、保持稳定还是下降？
数据来自于“最年长者资产与健康动态研究”（AHEAD）队列1993 - 2010年的数据。队列成员在1993年时年龄在70岁及以上（平均年龄 = 77.5岁），到2010年幸存者年龄在87岁及以上（平均年龄 = 90.2岁）。研究了个人护理残疾（日常生活活动）、家务管理残疾（日常生活工具性活动）和身体限制情况。我们研究了在世队列随时间变化的平均残疾状况以及死亡者和幸存者群体的残疾病史。
在世队列的平均残疾水平随时间逐渐上升。较早死亡的群体平均残疾水平高于较晚死亡的群体。接近死亡时，所有死亡群体的残疾水平急剧上升。存活时间较长的群体平均残疾水平较低，且残疾增长速度比存活时间较短的群体慢。所有结果在较年轻的队列成员（基线年龄 = 70 - 79岁）、较年长的成员（基线年龄 = 80岁及以上）、女性和男性中都得到了重复验证。
随着队列年龄的增长，在世成员的平均残疾水平逐渐增加，这表明非常年长者在行为、心理和生理方面的健康状况良好。
