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在以色列老年人中,哪类终身性逆境会加速身体机能衰退?

Which category of lifetime adversity accelerates physical impairment among Israeli older adults?

作者信息

Shrira Amit, Palgi Yuval, Bodner Ehud, Shmotkin Dov

机构信息

Interdisciplinary Department of Social Sciences, Bar-Ilan University, 5290002 Ramat Gan, Israel.

Department of Gerontology and the Center for Research and Study of Aging, University of Haifa, Haifa, Israel.

出版信息

Eur J Ageing. 2016 Feb 27;13(4):323-334. doi: 10.1007/s10433-016-0366-3. eCollection 2016 Dec.

Abstract

Preliminary evidence suggests that exposure to lifetime cumulative adversity is related to faster increase in physical impairment with time, especially when depressive symptoms are present. Nevertheless, it is still unclear whether different adversity categories accelerate impairment. The current study capitalized on the unique accounts of adversity available in the Israeli component of the Survey of Health, Ageing and Retirement in Europe (SHARE-Israel) by focusing on different categories of adversity, while accounting for their interaction with depressive symptoms in predicting trajectories of physical impairment (i.e., chronic medical conditions and disability). Data of 1665 participants (mean age = 63.08, SD = 10.04 at Wave 1) were drawn from the first three waves of SHARE-Israel. Respondents reported exposure to bereavement (e.g., experiencing the death of a spouse), war and terrorism (e.g., being wounded in terrorist attack), and victimization (e.g., being a victim of abuse or assault). Other measures assessed depressive symptoms, chronic medical conditions, and disability. Growth-curve models showed that bereavement and exposure to war and terrorism were related to specific measures of physical impairment. Moreover, three-way interactions showed that clinical level of depressive symptoms coupled with exposure to either bereavement or war and terrorism predicted a faster increase in chronic medical conditions and disability. The findings offer a differentiated outlook on the effect of adversity on age-related increase in physical impairment. Practitioners should consider that older adults previously exposed to bereavement, war and terrorism are at risk for a hastened physical decline, especially when they suffer from depressive symptoms.

摘要

初步证据表明,一生中累积暴露于逆境与身体机能随时间更快下降有关,尤其是在存在抑郁症状时。然而,不同类型的逆境是否会加速身体机能下降仍不清楚。当前的研究利用了欧洲健康、老龄化和退休调查(SHARE)以色列部分中有关逆境的独特记录,重点关注不同类型的逆境,同时在预测身体机能下降轨迹(即慢性疾病和残疾)时考虑它们与抑郁症状的相互作用。1665名参与者(第1波时的平均年龄 = 63.08,标准差 = 10.04)的数据来自SHARE以色列的前三波调查。受访者报告了经历过丧亲之痛(例如,配偶去世)、战争和恐怖主义事件(例如,在恐怖袭击中受伤)以及受侵害情况(例如,遭受虐待或攻击)。其他测量指标包括抑郁症状、慢性疾病和残疾情况。增长曲线模型表明,丧亲之痛以及经历战争和恐怖主义事件与身体机能下降的特定指标有关。此外,三因素交互作用表明,临床水平的抑郁症状加上经历丧亲之痛或战争和恐怖主义事件,预示着慢性疾病和残疾情况会更快增加。这些发现为逆境对与年龄相关的身体机能下降的影响提供了不同的见解。从业者应考虑到,曾经历丧亲之痛、战争和恐怖主义事件的老年人身体机能加速衰退的风险更大,尤其是当他们患有抑郁症状时。

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