Bravell Marie Ernsth, Zarit Steven H, Johansson Boo
Institute of Gerontology, School of Health Sciences, Jönköping University, P. O. Box 1026, 551 11 Jönköping, Sweden.
Department of Human Development and Family Studies, Penn State University, Henderson S-211, University Park, PA 16802 USA.
Eur J Ageing. 2011 Jun 24;8(3):199-209. doi: 10.1007/s10433-011-0192-6. eCollection 2011 Sep.
Although researchers and clinicians tend to use subjective evaluations of functioning and objective assessments interchangeably, there may be important differences between how people view their own abilities and objective indicators. This study aims to examine the relation between self-reported evaluations of function and health and performance-based (PB) measures of functional ability and objective health indicators in a sample of the oldest old. The study is based on data from a sample of 349 individuals aged 80 and older from the OCTO-Twin Study. One member of each twin pair was randomly selected for this study. The result demonstrates that subjective evaluations of functional ability are significantly associated with objective measures of health and PB measures of function although considerable variance remained unexplained. The association of PB measures to the self-report evaluations differed by measure. PB measures had stronger associations with self-reported functioning than objective health indicators such as diseases and medications. PB balance was related to self-reported function in instrumental activities in daily life (IADL) and self-reported mobility, whereas PB upper body strength and flexibility was associated with all three self-reports of function but not to perceived health. The strength of these associations did not differ from one another suggesting that PB balance and upper body strength and flexibility have comparable effects on self-reports of daily life function. From a practical perspective, our findings confirm that self-reported ADL reflects objective measures of functioning, but probably also has subjective components that need further exploration. The result also indicates a need for multiple measures in evaluating functional ability in the oldest old.
尽管研究人员和临床医生倾向于互换使用功能的主观评估和客观评估，但人们对自身能力的看法与客观指标之间可能存在重要差异。本研究旨在检验在最年长的老年人样本中，自我报告的功能和健康评估与基于表现的（PB）功能能力测量及客观健康指标之间的关系。该研究基于来自OCTO双胞胎研究中349名80岁及以上个体样本的数据。每对双胞胎中的一名成员被随机选入本研究。结果表明，功能能力的主观评估与健康的客观测量以及功能的PB测量显著相关，尽管仍有相当大的差异无法解释。PB测量与自我报告评估的关联因测量方式而异。PB测量与自我报告的功能的关联比疾病和药物等客观健康指标更强。PB平衡与日常生活工具性活动（IADL）中的自我报告功能以及自我报告的活动能力相关，而PB上身力量和灵活性与所有三项功能的自我报告相关，但与感知健康无关。这些关联的强度彼此无差异，表明PB平衡以及上身力量和灵活性对日常生活功能的自我报告具有可比的影响。从实际角度来看，我们的研究结果证实，自我报告的日常生活活动反映了功能的客观测量，但可能也有需要进一步探索的主观成分。结果还表明，在评估最年长老年人的功能能力时需要采用多种测量方法。
