Pinto Jayant M, Wroblewski Kristen E, Huisingh-Scheetz Megan, Correia Camil, Lopez Kevin J, Chen Rachel C, Kern David W, Schumm Philip L, Dale William, McClintock Martha K
Section of Otolaryngology-Head and Neck Surgery, University of Chicago, Chicago, Illinois.
Center on Demography and Economics of Aging, University of Chicago, Chicago, Illinois.
J Am Geriatr Soc. 2017 Dec;65(12):2587-2595. doi: 10.1111/jgs.15031. Epub 2017 Sep 24.
To evaluate global sensory impairment (GSI, an integrated measure of sensory dysfunction) as a predictor of physical function, cognition, overall health, and mortality.
Prospective study.
The National Social Life, Health, and Aging Project.
A national probability sample of 3,005 home-dwelling older U.S. adults assessed at baseline (2005-06) and 5-year follow-up (2010-11).
Gait speed, activity, disability, cognition, overall health, 5-year mortality.
At baseline, older adults with worse GSI were slower (Timed Up and Go times: odds ratio (OR) = 1.32, 95% confidence interval (CI) = 1.17-1.50) and had more activity of daily living deficits (≥2: OR = 1.26, 95% CI = 1.10-1.46). Five years later, they were still slower (timed walk: OR = 1.22, 95% CI = 1.05-1.42), had more disabilities (≥2 instrumental activities of daily living; OR = 1.45, 95% CI = 1.23-1.70), were less active (daytime activity according to accelerometry: β = -2.7, 95% CI = -5.2 to -0.2), had worse cognitive function (Montreal Cognitive Assessment; β = -0.64, 95% CI = -0.84 to -0.44), more likely to have poorer overall health (OR = 1.16, 95% CI = 1.03-1.31) and lose weight (>10%: OR = 1.31, 95% CI = 1.04-1.64), and have died (OR = 1.45, 95% CI = 1.19-1.76). All analyses were adjusted for relevant confounders at baseline, including age, sex, race and ethnicity, education, smoking, problem drinking, body mass index, comorbidities, and cognitive function.
GSI predicts impaired physical function, cognitive dysfunction, significant weight loss, and mortality 5 years later in older U.S. adults. Multisensory evaluation may identify vulnerable individuals, offering the opportunity for early intervention to mitigate adverse outcomes.
评估整体感觉障碍(GSI,一种感觉功能障碍的综合测量指标)作为身体功能、认知、整体健康和死亡率预测指标的价值。
前瞻性研究。
美国国家社会生活、健康与老龄化项目。
对3005名居家生活的美国老年人进行全国概率抽样,在基线期(2005 - 2006年)和5年随访期(2010 - 2011年)进行评估。
步速、活动能力、残疾情况、认知、整体健康、5年死亡率。
在基线期,GSI较差的老年人步速较慢(计时起立行走时间:优势比(OR)= 1.32,95%置信区间(CI)= 1.17 - 1.50),日常生活活动缺陷更多(≥2项:OR = 1.26,95% CI = 1.10 - 1.46)。5年后,他们仍然步速较慢(定时步行:OR = 1.22,95% CI = 1.05 - 1.42),残疾更多(≥2项日常生活工具性活动;OR = 1.45,95% CI = 1.23 - 1.70),活动较少(根据加速度计测量的白天活动:β = -2.7,95% CI = -5.2至 -0.2),认知功能较差(蒙特利尔认知评估;β = -0.64,95% CI = -0.84至 -0.44),整体健康状况较差的可能性更大(OR = 1.16,95% CI = 1.03 - 1.31),体重减轻更多(>10%:OR = 1.31,95% CI = 1.04 - 1.64),并且死亡(OR = 1.45,95% CI = 1.19 - 1.76)。所有分析均对基线期的相关混杂因素进行了调整,包括年龄、性别、种族和民族、教育程度(学历)、吸烟、问题饮酒、体重指数、合并症和认知功能。
GSI可预测美国老年人5年后身体功能受损、认知功能障碍、显著体重减轻和死亡率。多感官评估可能识别出易受伤害的个体,为早期干预以减轻不良后果提供机会。