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从 70 岁到 95 岁期间,出门频率与死亡率之间的关系。

Frequency of Leaving the House and Mortality from Age 70 to 95.

机构信息

Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center, and Hebrew University-Hadassah Medical School, Jerusalem, Israel.

Department of Geriatrics and Rehabilitation, Hadassah-Hebrew University Medical Center, and Hebrew University-Hadassah Medical School, Jerusalem, Israel.

出版信息

J Am Geriatr Soc. 2018 Jan;66(1):106-112. doi: 10.1111/jgs.15148. Epub 2017 Nov 22.

Abstract

OBJECTIVES

To determine the association between frequency of leaving the house and mortality.

DESIGN

Prospective follow-up of an age-homogenous, representative, community-dwelling birth cohort (born 1920-21) from the Jerusalem Longitudinal Study (1990-2015).

SETTING

Home.

PARTICIPANTS

Individuals aged 70 (n = 593), 78 (n = 973), 85 (n = 1164), and 90 (n = 645), examined in 1990, 1998, 2005, and 2010, respectively.

MEASUREMENTS

Frequency of leaving the house, defined as daily (6-7/week), often (2-5/week), and rarely (≤1/week); geriatric assessment; all-cause mortality (2010-15). Kaplan-Meier survival charts and proportional hazards models adjusted for social (sex, marital status, financial status, loneliness), functional (sex, self-rated health, fatigue, depression, physical activity, activity of daily living difficulty), and medical (sex, chronic pain, visual impairment, hearing impairment, diabetes mellitus, hypertension, ischemic heart disease, chronic kidney disease) covariates.

RESULTS

At ages 70, 78, 85, and 90, frequency of going out daily was 87.0%, 80.6%, 65.6%, and 48.4%; often was 6.4%, 9.5%, 17.4%, and 11.3%; and rarely was 6.6%, 10.0%, 17.0%, and 40.3% respectively. Decreasing frequency of going out was associated with negative social, functional, and medical characteristics. Survival rates were lowest among those leaving rarely and highest among those going out daily throughout follow-up. Similarly, compared with rarely leaving the house, unadjusted mortality hazard ratios (HRs) were lowest among subjects leaving daily and remained significant after adjustment for social, functional and medical covariates. Among subjects leaving often, unadjusted HRs showed a similar effect of smaller magnitude, with attenuation of significance after adjustment in certain models. Findings were unchanged after excluding subjects dying within 6 months of follow-up.

CONCLUSION

In community-dwelling elderly adults aged 70 to 90, leaving the house daily was associated with lower mortality risk, independent of social, functional, or medical status.

摘要

目的

确定外出频率与死亡率之间的关联。

设计

对来自耶路撒冷纵向研究(1990-2015 年)的年龄同质、有代表性的社区居住出生队列(1920-21 年出生)进行前瞻性随访。

地点

家。

参与者

分别于 1990 年、1998 年、2005 年和 2010 年接受检查的年龄为 70 岁(n=593)、78 岁(n=973)、85 岁(n=1164)和 90 岁(n=645)的个体。

测量方法

外出频率定义为每天(6-7/周)、经常(2-5/周)和很少(每周≤1 次);老年评估;全因死亡率(2010-15 年)。Kaplan-Meier 生存图和比例风险模型调整了社会因素(性别、婚姻状况、经济状况、孤独感)、功能因素(性别、自我报告的健康状况、疲劳、抑郁、身体活动、日常生活活动困难)和医疗因素(性别、慢性疼痛、视力障碍、听力障碍、糖尿病、高血压、缺血性心脏病、慢性肾脏病)。

结果

在 70 岁、78 岁、85 岁和 90 岁时,每天外出的频率分别为 87.0%、80.6%、65.6%和 48.4%;经常外出的频率分别为 6.4%、9.5%、17.4%和 11.3%;很少外出的频率分别为 6.6%、10.0%、17.0%和 40.3%。外出频率降低与负面的社会、功能和医疗特征有关。在整个随访期间,很少外出的人群的生存率最低,而每天外出的人群的生存率最高。同样,与很少外出相比,不调整社会、功能和医疗混杂因素时,每天外出的人群的死亡率危险比(HR)最低,调整混杂因素后仍有统计学意义。在经常外出的人群中,未调整的 HR 显示出较小的影响,在某些模型中调整后显著性减弱。排除随访后 6 个月内死亡的人群后,结果保持不变。

结论

在 70 至 90 岁的社区居住老年人中,每天外出与较低的死亡率风险相关,独立于社会、功能或医疗状况。

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