Departments of Public Health, Nagasaki, Japan.
Department of Rehabilitation, Nishi-Isahaya Hospital, Isahaya, Japan.
Geriatr Gerontol Int. 2017 Jul;17(7):1096-1101. doi: 10.1111/ggi.12834. Epub 2016 Jul 12.
AIM: The purposes of the present study were to investigate risk factors for incident disability in activities of daily living (ADL) among middle-aged and older women, and to determine whether there are differences in risk factors according to age groups. METHODS: The participants were 264 Japanese women aged 40 years and older. A self-administered questionnaire was used to survey participants about difficulty in carrying out selected basic and instrumental ADL at baseline and at follow up. ADL disability was defined as difficulty carrying out three or more ADL. Information on knee joint or back pain and comorbidities (heart disease, lung disease, stroke or diabetes mellitus) was obtained using a self-administered questionnaire at baseline. Physical performance measurements (grip strength, chair stand time, rapid walking speed and functional reach) were also carried out at baseline. RESULTS: The prevalence of incident ADL disability was 44 (27.5%) in women aged 40-64 years, and 57 (54.8%) in women aged ≥65 years (P < 0.001). Multiple logistic regression analysis showed that decreased grip strength and having pain were significantly associated with a higher risk for incident ADL disability among women aged 40-64 years. For women aged ≥65 years, decreased rapid walking speed, having a comorbidity and having pain were associated with incident ADL disability. CONCLUSIONS: The present study showed that a different set of risk factors was associated with incident ADL disability among women aged 40-64 years and women aged ≥65 years. Age-specific screening and intervention strategies are necessary for effective prevention of incident ADL disability. Geriatr Gerontol Int 2017; 17: 1096-1101.
目的:本研究旨在探讨中年及以上女性日常生活活动(ADL)发生残疾的危险因素,并确定是否存在按年龄分组的危险因素差异。
方法:研究对象为 264 名年龄在 40 岁及以上的日本女性。在基线和随访时,使用自我管理问卷调查参与者在进行特定基本和工具性 ADL 时的困难程度。ADL 残疾定义为进行 3 项或更多 ADL 有困难。在基线时,使用自我管理问卷获取膝关节或背部疼痛以及合并症(心脏病、肺病、中风或糖尿病)的信息。还在基线时进行了身体机能测量(握力、椅立时间、快速行走速度和功能伸展)。
结果:40-64 岁女性中 ADL 新发残疾的患病率为 44 例(27.5%),≥65 岁女性中为 57 例(54.8%)(P<0.001)。多变量逻辑回归分析显示,握力下降和疼痛与 40-64 岁女性 ADL 新发残疾风险增加显著相关。对于≥65 岁的女性,快速行走速度下降、合并症和疼痛与 ADL 新发残疾相关。
结论:本研究表明,40-64 岁和≥65 岁女性发生 ADL 残疾的危险因素不同。需要针对特定年龄组制定特定的筛查和干预策略,以有效预防 ADL 新发残疾。老年医学与老年病学杂志 2017;17:1096-1101。
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