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衡量积极健康老龄化:应用一个纳入国际功能、残疾和健康分类(ICF)的通用跨学科评估模型。

Measuring Active and Healthy Ageing: Applying a GENERIC Interdisciplinary Assessment Model Incorporating ICF.

作者信息

Stute P, Bitterlich N, Bousquet J, Meissner F, von Wolff M, Poethig D

机构信息

Professor Dr. med. Petra Stute, M.D. Department of Gynecologic Endocrinology and Reproductive Medicine, University Clinic of Obstetrics and Gynecology, Inselspital Bern, Effingerstrasse 102, 3010 Bern, Switzerland, Telephone: (0)31-632-1303, Fax: (0)31-632-1332, Email:

出版信息

J Nutr Health Aging. 2017;21(9):1002-1009. doi: 10.1007/s12603-017-0908-1.

Abstract

OBJECTIVES

In this study we compared the chronological and bio-functional age between two German speaking cohorts 30 years apart applying a comprehensive and generic Active and Healthy Aging (AHA) assessment model incorporating ICF.

METHODS

Single-centre, cross-sectional, observational, non-interventional, non-randomized trial at an University based women's hospital, division of Gynecological Endocrinology and Reproductive Medicine. All participants followed a standardized, holistic battery of biopsychosocial assessments consisting of bio-functional status (BFS), bio-functional age (BFA) and additional validated psychometric questionnaires.

RESULTS

462 non-pediatric, non-geriatric females were in the BeCS-14 cohort. The measured mean BFA was lower than the chronological age within the BeCS-14 cohort (regression coefficient 0.58) and comparable in the female LeCS-84 subcohort (regression coefficient age 0.85, communality age 76%). In detail, within the decades 35-45 years and 55-65 years the gradient of BFA increase (aging rate) was similar in both cohorts (decade 35-45 years: LeCS-84 4.08 ± 1.03 year equivalents and BeCS-14 4.78 ± 1.67 year equivalents; decade 55-65 years: LeCS-84 6.21 ± 1.29 year equivalents and BeCS-14 5.25 ± 1.18 year equivalents). Remarkably, within the LeCS-84 cohort the mean aging rate within the decade 45-55 years was significantly different from all other aging rates in both cohorts: 13.02 ± 1.05 year equivalents. However, within the BeCS-14 cohort the corresponding value was 4.83 ± 1.02 year equivalents thus indicating a continuous aging process across the adult life course. In BeCS-14, there was a significant age-related effect for cardiovascular performance and social stress exposition and younger age was associated with better cardiovascular performance while level of social stress exposition decreased in aging women.

CONCLUSION

When comparing BeCS-14 and LeCS-84, the aging process seemed to be accelerated in women in LeCS-84 between 45 and 54 years of age. We can only speculate on the reasons, such as differences in the health care, political and social system. However, the differences observed support the use of our BFS/BFA assessment tool not only on an individual level (strengths/resources) but also population level following EIP-AHA requirements. Yet, it remains to be developed how the assessed health strengths/resources-profile may be integrated into AHA management.

摘要

目的

在本研究中,我们应用一个纳入国际功能、残疾和健康分类(ICF)的全面通用的积极健康老龄化(AHA)评估模型,比较了相隔30年的两个德语队列的实足年龄和生物功能年龄。

方法

在一所大学附属医院的妇科内分泌与生殖医学科进行单中心、横断面、观察性、非干预、非随机试验。所有参与者均接受了一套标准化的、全面的生物心理社会评估,包括生物功能状态(BFS)、生物功能年龄(BFA)以及其他经过验证的心理测量问卷。

结果

BeCS - 14队列中有462名非儿科、非老年女性。在BeCS - 14队列中,测得的平均BFA低于实足年龄(回归系数0.58),在女性LeCS - 84亚队列中两者相当(年龄回归系数0.85,共同性年龄76%)。详细而言,在35 - 45岁和55 - 65岁这两个十年中,两个队列中BFA增加的梯度(衰老率)相似(35 - 45岁十年:LeCS - 84为4.08±1.03岁当量,BeCS - 14为4.78±1.67岁当量;55 - 65岁十年:LeCS - 84为6.21±1.29岁当量,BeCS - 14为5.25±1.18岁当量)。值得注意的是,在LeCS - 84队列中,45 - 55岁十年内的平均衰老率与两个队列中的所有其他衰老率显著不同:为13.02±1.05岁当量。然而,在BeCS - 14队列中,相应的值为4.83±1.02岁当量,这表明在成年生命历程中衰老过程是持续的。在BeCS - 14中,心血管功能和社会压力暴露存在显著的年龄相关效应,年龄较小与更好的心血管功能相关,而老年女性的社会压力暴露水平降低。

结论

比较BeCS - 14和LeCS - 84时,LeCS - 84队列中45至54岁的女性衰老过程似乎加速。我们只能推测其原因,如医疗保健、政治和社会制度的差异。然而,观察到的数据差异支持我们的BFS/BFA评估工具不仅可用于个体层面(优势/资源),也可根据欧洲创新伙伴关系 - 积极健康老龄化(EIP - AHA)的要求用于人群层面。然而,如何将评估的健康优势/资源概况整合到AHA管理中仍有待进一步研究。

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