Karppinen Helena, Pitkälä Kaisu H, Kautiainen Hannu, Tilvis Reijo S, Valvanne Jaakko, Yoder Käthe, Strandberg Timo E
a General Practice and Primary Health Care , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
b Primary Health Care Unit , Kuopio University Hospital , Kuopio , Finland.
Scand J Prim Health Care. 2017 Sep;35(3):279-285. doi: 10.1080/02813432.2017.1358855. Epub 2017 Aug 7.
To explore changes in self-reported disabilities, health, comorbidities and psychological wellbeing (PWB) in aged cohorts over two decades.
DESIGN, SETTING AND SUBJECTS: Cross-sectional cohort studies with postal surveys were conducted among community-dwelling people aged 75, 80, 85, 90 and 95 years in 1989 (n = 660), 1999 (n = 2598) and 2009 (n = 1637) in Helsinki, Finland.
Self-reported items on disability, self-rated health (SRH), diagnoses and PWB were compared between cohorts of the same age. Standardized mortality ratios (SMRs) were calculated for each study year to explore the representativeness of the samples compared to general population of same age.
A significantly lower proportion of the 75-85-year-olds of the later study years reported going outdoors daily, although this group had improvements in both SRH and PWB scores. The number of comorbidities increased over time among 75-85-year-olds. The only significant change that could be verified among 90- and 95-year-olds between 1999 and 2009, was the lower proportion of participants going outdoors daily. The trend of leveling-off in disabilities was not explained by the SMRs (0.90, 0.71 and 0.60 for 1989, 1999 and 2009).
The latest older people's cohorts showed an end to previously reported improvements in disabilities, despite having favorable trends in SRH and PWB. Primary care may be faced with increasing need of appropriate services for their senior members.
探讨二十多年来老年人群自我报告的残疾、健康、合并症及心理健康状况的变化。
设计、背景与研究对象:1989年(n = 660)、1999年(n = 2598)和2009年(n = 1637)在芬兰赫尔辛基对年龄分别为75、80、85、90和95岁的社区居民进行了邮政调查的横断面队列研究。
比较同一年龄组人群自我报告的残疾项目、自评健康状况(SRH)、诊断结果及心理健康状况。计算各研究年份的标准化死亡率(SMR),以探讨样本与同年龄一般人群相比的代表性。
在后期研究年份中,75 - 85岁人群中报告每天外出的比例显著降低,尽管该组的SRH和心理健康状况评分均有所改善。75 - 85岁人群的合并症数量随时间增加。1999年至2009年间,90岁和95岁人群中唯一可证实的显著变化是每天外出的参与者比例降低。残疾状况趋于平稳的趋势无法用SMR来解释(分别为1989年0.90、1999年0.71和2009年0.60)。
尽管最新的老年人群在SRH和心理健康方面呈良好趋势,但先前报告的残疾改善情况已终止。初级保健可能面临为其老年成员提供更多适当服务的需求。