老年人心血管健康和自评健康可改变指标的历史趋势：柏林衰老研究（BASE）与柏林衰老研究II（BASE-II）20年间的队列差异。
Historical trends in modifiable indicators of cardiovascular health and self-rated health among older adults: Cohort differences over 20 years between the Berlin Aging Study (BASE) and the Berlin Aging Study II (BASE-II).
作者信息
König Maximilian, Drewelies Johanna, Norman Kristina, Spira Dominik, Buchmann Nikolaus, Hülür Gizem, Eibich Peter, Wagner Gert G, Lindenberger Ulman, Steinhagen-Thiessen Elisabeth, Gerstorf Denis, Demuth Ilja
机构信息
Lipid Clinic at the Interdisciplinary Metabolism Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Department of Psychology, Humboldt University Berlin, Berlin, Germany.
出版信息
PLoS One. 2018 Jan 31;13(1):e0191699. doi: 10.1371/journal.pone.0191699. eCollection 2018.
BACKGROUND
The last decades have seen great advances in the understanding, treatment, and prevention of cardiovascular disease (CVD). Although mortality rates due to CVD have declined significantly in the last decades, the burden of CVD is still high, particularly in older adults. This raises the question whether contemporary populations of older adults are experiencing better or worse objective as well as subjective health than earlier-born cohorts. The aim of this study was to examine differences in modifiable indicators of cardiovascular health (CVH), comparing data obtained 20 years apart in the Berlin Aging Study (BASE, 1990-93) and the Berlin Aging Study II (BASE-II, 2009-2014).
METHODS
Serial cross-sectional analysis of 242 propensity-score-matched participants of BASE (born 1907-1922) and BASE-II (born 1925-1942). Body mass index (BMI), blood pressure, total cholesterol, glycated hemoglobin (HbA1c), diet, smoking and physical activity were operationalized according to the "Life's simple 7"(LS7) criteria of the American Heart Association.
RESULTS
121 matched pairs were identified based on age, sex, and education. In the later-born BASE-II sample, the mean LS7 score was significantly higher than in the earlier-born sample (7.8±1.8 vs. 6.4±2.1, p<0.001), indicating better CVH. In detail, diet, physical activity, smoking, cholesterol, and HbA1c were more favorable, whereas blood pressure was significantly higher in individuals from the later-born cohort. BMI did not differ significantly between the two matched samples. Notably, despite better CVH, later-born individuals (BASE-II) reported lower self-rated health, presumably because of higher health expectations.
CONCLUSIONS
Overall, cardiovascular health was significantly better in the later-born cohort, but several notable exceptions exist.
背景
在过去几十年里，人们对心血管疾病（CVD）的认识、治疗和预防取得了巨大进展。尽管在过去几十年中，心血管疾病的死亡率显著下降，但心血管疾病的负担仍然很高，尤其是在老年人中。这就引发了一个问题，即当代老年人群体的客观和主观健康状况与早出生的队列相比是更好还是更差。本研究的目的是检查心血管健康（CVH）可改变指标的差异，比较在柏林衰老研究（BASE，1990 - 93年）和柏林衰老研究II（BASE-II，2009 - 2014年）中相隔20年获得的数据。
方法
对BASE（出生于1907 - 1922年）和BASE-II（出生于1925 - 1942年）的242名倾向得分匹配参与者进行系列横断面分析。根据美国心脏协会的“生命简单7项”（LS7）标准对体重指数（BMI）、血压、总胆固醇、糖化血红蛋白（HbA1c）、饮食、吸烟和身体活动进行评估。
结果
根据年龄、性别和教育程度确定了121对匹配对象。在晚出生的BASE-II样本中，平均LS7得分显著高于早出生的样本（7.8±1.8对6.4±2.1，p<0.001），表明心血管健康状况更好。具体而言，饮食、身体活动、吸烟、胆固醇和HbA1c情况更有利，而晚出生队列个体的血压显著更高。两个匹配样本之间的BMI没有显著差异。值得注意的是，尽管心血管健康状况更好，但晚出生的个体（BASE-II）报告的自评健康状况较低，可能是因为健康期望更高。
结论
总体而言，晚出生队列的心血管健康状况明显更好，但也存在一些显著例外。
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