Kamiya Kuniyasu, Adachi Takuji, Sasou Kenji, Suzuki Tadashi, Yamada Sumio
Program in Physical and Occupational Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Welfare Department, CO-OP AICHI Consumer Co-operative Society, Toyokawa, Japan.
Geriatr Gerontol Int. 2017 Apr;17(4):568-574. doi: 10.1111/ggi.12756. Epub 2016 Apr 21.
To examine the predictive ability of memory deterioration and grip strength for disability progression among those who utilized the home-help service.
We prospectively followed a cohort of community-dwelling older people who were aged 65 years or older, certified support level 1-2 or care level 1-2 and home-help service users provided by Consumers' Cooperatives in Aichi and Kanagawa prefecture. Memory capability, grip strength, chronic conditions and other indices were surveyed at baseline. Disability progression was defined as being certified care level 3 or higher, or institutionalization during 3-year follow up.
We assessed 417 older adults, of which 386 were included (7.4% excluded). In multivariate Cox regression analyses, a higher eligibility level and memory deterioration were independently associated with a higher hazard ratio. When chronic conditions were entered in the model, cancer and low grip strength were additionally associated.
The findings of the present study show that memory deterioration is a risk factor for disability progression. Also, grip strength might be a risk factor with consideration of chronic conditions. The cause-effect relationship of those factors and disability progression would be a future challenging issue. Geriatr Gerontol Int 2017; 17: 568-574.
研究记忆力减退和握力对使用居家护理服务人群残疾进展的预测能力。
我们对一组居住在社区的老年人进行了前瞻性随访，这些老年人年龄在65岁及以上，认证支持级别为1 - 2级或护理级别为1 - 2级，并且是爱知县和神奈川县消费者合作社提供居家护理服务的使用者。在基线时对记忆能力、握力、慢性疾病和其他指标进行了调查。残疾进展定义为在3年随访期间被认证为护理级别3级或更高，或入住养老院。
我们评估了417名老年人，其中386名被纳入研究（排除7.4%）。在多变量Cox回归分析中，较高的资格水平和记忆力减退与较高的风险比独立相关。当将慢性疾病纳入模型时，癌症和握力低也与之相关。
本研究结果表明，记忆力减退是残疾进展的一个风险因素。此外，考虑到慢性疾病，握力可能也是一个风险因素。这些因素与残疾进展之间的因果关系将是未来一个具有挑战性的问题。《老年医学与老年病学国际杂志》2017年；17: 568 - 574。
