Zunzunegui M V, Rodriguez-Laso A, Otero A, Pluijm S M F, Nikula S, Blumstein T, Jylhä M, Minicuci N, Deeg D J H
Département de Médecine Sociale et Préventive, Faculté de Médecine, Université de Montréal, Succursale Centre-ville, Montréal, Québec H3C 3J7 Canada.
Centro Universitario de Salud Pública, Universidad Autonoma de Madrid, Madrid, Spain.
Eur J Ageing. 2005 Mar;2(1):40-47. doi: 10.1007/s10433-005-0021-x. Epub 2005 Mar 4.
The associations between prevalence, incidence and recovery from activities of daily living (ADL) disability and social ties among community-dwelling persons over 65 in Finland, The Netherlands and Spain are examined. Data were harmonized in the CLESA study. The baseline sample was composed of 3,648 subjects between 65 and 85 years old, living in Finland, The Netherlands and Spain. Disability in four activities of daily living was determined at baseline and at follow-up. Social participation, number of family ties and presence of friends were added to obtain a social ties index. Logistic regressions were fitted to the prevalence, incidence and recovery data to estimate the associations between disability and social ties, adjusting for education, co-morbidity and self-rated health. The modifying effects of country, age and sex were tested in all models. For every country, the social ties index, having friends and social participation were negatively associated with ADL disability prevalence. ADL incidence was negatively related to the number of family ties, with a stronger relationship in Spain than in The Netherlands or Finland. ADL recovery was associated with the social ties index. No age or gender differences in these associations were found. Social ties appear to generate a beneficial effect on the maintenance and restoration of ADL function. While social ties play an important role in maintaining and restoring function in all three countries, family ties appear to generate a stronger effect on protection from disability incidence than does social participation, and the strength of this effect varies by culture.
本文研究了芬兰、荷兰和西班牙65岁以上社区居民日常生活活动（ADL）残疾的患病率、发病率及康复情况与社会关系之间的关联。数据来自CLESA研究并进行了统一处理。基线样本由3648名年龄在65至85岁之间、居住在芬兰、荷兰和西班牙的受试者组成。在基线和随访时确定四项日常生活活动的残疾情况。加入社会参与度、家庭关系数量和朋友的存在情况以获得社会关系指数。对患病率、发病率和康复数据进行逻辑回归分析，以估计残疾与社会关系之间的关联，并对教育程度、合并症和自评健康状况进行调整。在所有模型中检验国家、年龄和性别的调节作用。对于每个国家，社会关系指数、有朋友以及社会参与度均与ADL残疾患病率呈负相关。ADL发病率与家庭关系数量呈负相关，在西班牙的相关性强于荷兰或芬兰。ADL康复与社会关系指数相关。在这些关联中未发现年龄或性别差异。社会关系似乎对ADL功能的维持和恢复产生有益影响。虽然社会关系在所有三个国家的功能维持和恢复中都发挥着重要作用，但家庭关系在预防残疾发病率方面似乎比社会参与产生更强的影响，并且这种影响的强度因文化而异。
