Burns Richard A, Browning Colette, Kendig Hal L
Centre for Research on Ageing,Health and Wellbeing,The Research School of Population Health,The Australian National University,Canberra,ACT,Australia.
ARC Centre of Excellence in Population Ageing Research (CEPAR),The Australian National University,Canberra,ACT,Australia.
Int Psychogeriatr. 2017 May;29(5):835-843. doi: 10.1017/S1041610216002398. Epub 2017 Jan 18.
Definitions of successful aging that incorporate dimensions of physical capacity and medical conditions are limited owing to the normative nature of experiencing medical conditions with age. We examine the capacity for older adults living in the community to live well with or without chronic disease as they age.
Participants (n = 1,001) were from the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA) study who were aged 65+ years at baseline, were living in the community and followed for 16 years.
Aging was associated with not living well (OR = 1.21; p < 0.001) and having a chronic disease (OR = 1.09; p < 0.001). There was increasing proportion of older adults not living well with chronic disease as they aged. Those not living well were at a substantial risk of death with (OR = 3.63; p < 0.001) or without (OR = 3.59; p < 0.001) chronic disease.
The defining normative experience for older adults is that they are more likely to have a chronic disease and importantly not be living well with chronic disease as they age. However, it was the state of not living well that reflected the most substantial vulnerability for mortality, not chronic disease.
由于随着年龄增长出现疾病状况具有规范性，纳入身体能力和疾病状况维度的成功老龄化定义受到限制。我们研究了社区中老年人随着年龄增长患慢性病或未患慢性病时生活得很好的能力。
参与者（n = 1001）来自墨尔本健康老龄化纵向研究（MELSHA），基线时年龄在65岁及以上，居住在社区，随访16年。
衰老与生活不佳（比值比=1.21；p<0.001）和患有慢性病（比值比=1.09；p<0.001）相关。随着年龄增长，患有慢性病但生活不佳的老年人比例不断增加。生活不佳的老年人无论是否患有慢性病都面临着很高的死亡风险（患有慢性病时比值比=3.63；p<0.001，未患慢性病时比值比=3.59；p<0.001）。
老年人的典型规范性经历是，随着年龄增长，他们更有可能患有慢性病，重要的是患有慢性病时生活不佳。然而，反映出死亡最主要脆弱性的是生活不佳的状态，而非慢性病。
