Stessman J, Rottenberg Y, Jacobs J M
Professor Jochanan Stessman, Institute of Aging Research, Department of Geriatrics and Rehabilitation, Hadassah Hebrew-University Medical Center, Mt. Scopus. P.O. Box 24035, Jerusalem 91240, Israel. E-mail:
J Nutr Health Aging. 2017;21(2):195-201. doi: 10.1007/s12603-016-0763-5.
Negotiating stairs is identified as a challenging task by older people, and using a handrail to climb stairs is a compensatory gait strategy to overcome mobility difficulties. We examine the association between handrail use to climb stairs at increasing ages, and long term survival.
Data were collected by the Jerusalem Longitudinal Study, which is a prospective study of a representative sample from the 1920-1921 birth-cohort living in West Jerusalem. Comprehensive assessment at home in 1990, 1998, and 2005, at ages 70 (n=446), 78 (n=897), and 85 (n=1041) included direct questioning concerning handrail use for climbing stairs. Mortality data were collected from age 70-90.
The frequency of handrail use to climb stairs at ages 70, 78, 85 years was 23.1% (n=103/446), 41.0% (n=368/897), and 86.7% (n=903/1041) respectively. Handrail use was associated throughout follow-up with a consistent pattern of negative demographic, functional and medical parameters. Between ages 70-78, 70-90, 78-85, 78-90, and 85-90, survival was significantly lower among subjects using a handrail, with unadjusted mortality Hazard Ratios of HR 1.57 (95%CI, 1.01-2.42), HR 1.65 (95%CI, 1.27-2.14), HR 1.78 (95%CI, 1.41-2.25), HR 1.71 (95%CI, 1.41-2.06), and HR 1.53 (95%CI, 1.01-2.33) respectively. HR's remained significant at all ages after adjusting for sociodemographic factors (gender, education, marital, and financial status), and common medical conditions (ischemic heart disease, hypertension, diabetes, chronic pain), as well as between ages 78-85 and 78-90 after adjusting for functional covariables (self-rated health, physical activity, depression, BMI and ADL difficulties).
Using a handrail to climb stairs is increasingly common with rising age, was associated with a negative profile of health parameters and is associated with subsequent mortality.
老年人认为上下楼梯是一项具有挑战性的任务，而使用扶手爬楼梯是一种克服行动困难的代偿性步态策略。我们研究了不同年龄段使用扶手爬楼梯与长期生存之间的关联。
数据由耶路撒冷纵向研究收集，该研究是对居住在耶路撒冷西部的1920 - 1921年出生队列的代表性样本进行的前瞻性研究。在1990年、1998年和2005年，分别对年龄为70岁（n = 446）、78岁（n = 897）和85岁（n = 1041）的人群进行了全面的居家评估，其中包括直接询问关于使用扶手爬楼梯的情况。收集了70至90岁的死亡率数据。
70岁、78岁、85岁时使用扶手爬楼梯的频率分别为23.1%（n = 103 / 446）、41.0%（n = 368 / 897）和86.7%（n = 903 / 1041）。在整个随访过程中，使用扶手与负面的人口统计学、功能和医学参数模式一致相关。在70 - 78岁、70 - 90岁、78 - 85岁、78 - 90岁和85 - 90岁之间，使用扶手的受试者生存率显著较低，未调整的死亡风险比分别为HR 1.57（95%CI，1.01 - 2.42）、HR 1.65（95%CI，1.27 - 2.14）、HR 1.78（95%CI，1.41 - 2.25）、HR 1.71（95%CI，1.41 - 2.06）和HR 1.53（95%CI，1.01 - 2.33）。在调整了社会人口学因素（性别、教育程度、婚姻状况和经济状况）、常见疾病（缺血性心脏病、高血压、糖尿病、慢性疼痛）后，各年龄段的HR值仍具有显著性；在调整了功能协变量（自评健康状况、身体活动、抑郁、BMI及日常生活活动困难）后，78 - 85岁和78 - 90岁之间的HR值也具有显著性。
随着年龄增长，使用扶手爬楼梯的情况越来越普遍，这与健康参数的负面情况相关，并且与随后的死亡率相关。
