Miyawaki Toshiyuki, Kumamoto Keigo, Shimoda Kaori, Tozato Fusae, Iwaya Tsutomu
Gunma University School of Health Sciences, 3-39-22 Showa-machi, Maebashi-City, Gunma Prefecture, 371-8514, Japan; Nagano University of Health and Medicine, 11-1 Imaihara Kawanakajima-machi, Nagano-City, Nagano Prefecture, 381-2227, Japan.
Nagano University of Health and Medicine, 11-1 Imaihara Kawanakajima-machi, Nagano-City, Nagano Prefecture, 381-2227, Japan.
J Orthop Sci. 2017 Mar;22(2):339-344. doi: 10.1016/j.jos.2016.12.010. Epub 2017 Jan 10.
Locomotive disorders are one of the main causative pathologies for the condition requiring assistance on activities of daily living (ADL). Although psychological concerns such as feeling of depression and anxiety are prevalent in elderly people, the causal relation among motor function, ADL disability, and psychological concerns is controversial.
Purpose of this study was to investigate causal relationship among motor function, ADL disability, and psychological concerns in elderly people with locomotive disorders.
The data for this study were from a community-dwelling sample of 314 elderly persons with locomotive disorders aged 65 and older who visited orthopedic clinics and/or affiliated institutions. Motor function was assessed by one-leg standing time with eyes open, leg extension power and grip power. We assessed ADL disability using the 25-question Geriatric Locomotive Function Scale (GLFS-25), and psychological concerns by three self-reported questions. We constructed two models and tested fitness of the models to the data using a structural equation modeling (SEM). Model 1: motor function affects ADL disability and ADL disability affects psychological concerns, Model 2: motor function affects psychological concerns and psychological concerns affects ADL disability.
The fit indices were chi-square = 23.152 (p = 0.081), RMSEA = 0.042, GFI = 0.981, AGFI = 0.955, CFI = 0.987 for Model 1, and chi-square = 84.583 (p < 0.001), RMSEA = 0.119, GFI = 0.935, AGFI = 0.854, CFI = 0.892 for Model 2. These fit indices indicated a good fit of the model 1 and inadequate fit of model 2 to the data.
Decline of motor function contributed toward psychological concerns via ADL disability in elderly people with locomotive disorders.
运动障碍是导致需要日常生活活动（ADL）协助的主要病因之一。尽管抑郁和焦虑等心理问题在老年人中普遍存在，但运动功能、ADL残疾和心理问题之间的因果关系仍存在争议。
本研究旨在调查患有运动障碍的老年人的运动功能、ADL残疾和心理问题之间的因果关系。
本研究的数据来自314名年龄在65岁及以上、患有运动障碍的社区老年人样本，这些老年人前往骨科诊所和/或附属机构就诊。运动功能通过睁眼单腿站立时间、腿部伸展力量和握力进行评估。我们使用25个问题的老年运动功能量表（GLFS-25）评估ADL残疾，并通过三个自我报告问题评估心理问题。我们构建了两个模型，并使用结构方程模型（SEM）测试模型与数据的拟合度。模型1：运动功能影响ADL残疾，ADL残疾影响心理问题；模型2：运动功能影响心理问题，心理问题影响ADL残疾。
模型1的拟合指数为卡方=23.152（p=0.081），RMSEA=0.042，GFI=0.981，AGFI=0.955，CFI=0.987；模型2的拟合指数为卡方=84.583（p<0.001），RMSEA=0.119，GFI=0.935，AGFI=0.854，CFI=0.892。这些拟合指数表明模型1与数据拟合良好，模型2与数据拟合不足。
在患有运动障碍的老年人中，运动功能下降通过ADL残疾导致心理问题。
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