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意大利社区老年人的无用感与3年死亡率:功能状态的作用

Feelings of uselessness and 3-year mortality in an Italian community older people: the role of the functional status.

作者信息

Curzio Olivia, Bernacca Emilia, Bianchi Bruno, Rossi Giuseppe

机构信息

Unit of Epidemiology and Biostatistics, Institute of Clinical Physiology, National Research Council, Pisa, Italy.

Geriatrics Department of Primary Health Care, Massa and Carrara Public Health Care System, Carrara, Italy.

出版信息

Psychogeriatrics. 2017 Sep;17(5):300-309. doi: 10.1111/psyg.12238. Epub 2017 Jan 27.

Abstract

BACKGROUND

Sense of self-worth influences the health status of the elderly and may be associated with mortality. The aim of the study was to investigate whether the association between subjective feelings of uselessness and mortality was confounded or modified by functional limitation in non-institutionalized older people.

METHODS

Participants were community-dwelling older people, aged 70 years and older, who lived in neighbourhoods of Massa and Carrara municipalities in northern Tuscany, Italy. At baseline, 2335 non-institutionalized older people were assessed with a short self-administered questionnaire; the analysis included 2132 older persons for whom vital statistical data were available after a 3-year follow-up.

RESULTS

The feeling of uselessness was associated with an increased mortality at the 3-year follow-up, but only in older people who reported disability problems (adjusted hazard ratio = 1.97, 95% confidence interval = 1.48-2.63, P < 0.0001).

CONCLUSIONS

People who reported disability problems and a feeling of uselessness may be vulnerable to an increased risk for poor health outcomes in later life. This study outlined the importance of enquiring about feelings of uselessness, which is a relational variable that is linked to both psychological and physical health status, especially in older people who need help in daily activities.

摘要

背景

自我价值感会影响老年人的健康状况,且可能与死亡率相关。本研究的目的是调查在非机构化老年人中,无用感与死亡率之间的关联是否会受到功能限制的混淆或改变。

方法

研究对象为居住在意大利托斯卡纳大区北部马萨和卡拉拉市社区的70岁及以上老年人。基线时,用一份简短的自填问卷对2335名非机构化老年人进行评估;分析纳入了2132名老年人,对其进行了3年随访并获取了生命统计数据。

结果

在3年随访中,无用感与死亡率增加相关,但仅在报告有残疾问题的老年人中如此(调整后风险比 = 1.97,95%置信区间 = 1.48 - 2.63,P < 0.0001)。

结论

报告有残疾问题且有无用感的人在晚年可能易面临健康状况不佳风险增加的情况。本研究概述了询问无用感的重要性,无用感是一个与心理和身体健康状况都相关的关系变量,尤其对于在日常活动中需要帮助的老年人。

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