Aro Anna-Kaisa, Karjalainen Merja, Tiihonen Miia, Kautiainen Hannu, Saltevo Juha, Haanpää Maija, Mäntyselkä Pekka
Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Finland; Rantakylä Health Center, Siunsote, Finland.
Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Finland.
Prim Care Diabetes. 2017 Dec;11(6):577-582. doi: 10.1016/j.pcd.2017.07.001. Epub 2017 Jul 25.
To evaluate the health-related quality of life (HRQoL) and functional capacity in relation to glycemic control among older home-dwelling primary care patients.
Electronic patient records were used to identify 527 people over 65 years with diabetes. Of these, 259 randomly selected subjects were invited to a health examination and 172 of them attended and provided complete data. The participants were divided into three groups based on the HbA1c: good (HbA1c<48mmol/mol (N=95)), intermediate (HbA1c 48-57mmol/mol (N=48)) and poor (HbA1c>57mmol/mol (N=29)) glycemic control. HRQoL was measured with the EuroQol EQ-5D questionnaire. Functional and cognitive capacity and mental well-being were assessed with the Lawton Instrumental Activities of Daily Living (IADL) scale, Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-15).
EQ-5D scores for good, intermediate and poor glycemic control were 0.78; 0.74 and 0.70, p=0.037. Sub-items of mobility (p=0.002) and self-care were the most affected (p=0.031). Corresponding trend was found for IADL, p=0.008. A significant correlation was found between MMSE scores and HbA1c.
Older primary care home-dwelling patients with diabetes and poorer glycemic control have lower functional capacity and HRQoL, especially in regard to mobility and self-care.
评估居家养老的老年初级保健患者中与血糖控制相关的健康相关生活质量（HRQoL）和功能能力。
使用电子病历识别527名65岁以上的糖尿病患者。其中，随机邀请259名受试者参加健康检查，172人参加并提供了完整数据。根据糖化血红蛋白（HbA1c）将参与者分为三组：血糖控制良好（HbA1c<48mmol/mol，n=95）、中等（HbA1c 48-57mmol/mol，n=48）和较差（HbA1c>57mmol/mol，n=29）。使用欧洲五维度健康量表（EuroQol EQ-5D）问卷测量HRQoL。使用Lawton日常生活工具活动（IADL）量表、简易精神状态检查表（MMSE）和老年抑郁量表（GDS-15）评估功能和认知能力以及心理健康状况。
血糖控制良好、中等和较差组的EQ-5D得分分别为0.78、0.74和0.70，p=0.037。活动能力（p=0.002）和自我护理的子项目受影响最大（p=0.031）。IADL也发现了相应趋势，p=0.008。MMSE得分与HbA1c之间存在显著相关性。
居家养老的老年糖尿病初级保健患者血糖控制较差，其功能能力和HRQoL较低，尤其是在活动能力和自我护理方面。
