Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
Geriatr Gerontol Int. 2018 Dec;18(12):1614-1619. doi: 10.1111/ggi.13539. Epub 2018 Oct 11.
The present study aimed to propose a structural model to explain the interaction of physical, cognitive and social domains of health status in the incidence of disability in community-dwelling people aged ≥75 years.
We analyzed 185 older adults (mean age 79.4 years, 58.4% female) who participated in a baseline assessment from 2012 to 2013. They were followed for incident certification of care needs in the national long-term care insurance certification system during the 2 years. Baseline assessments included several measurements related to the physical, cognitive and social domains of health status. We compared the model fit index between two hypothesis models - the parallel model and the hierarchical model - using structural equation modeling.
During the follow-up period, 15 participants (8.1%) were newly certified as requiring personal support from the long-term care insurance system. The structural equation modeling showed that the hierarchical model, indicating that cognitive and social status were indirectly associated with disability through physical status, had a better fit with the data than the parallel model, indicating that physical, cognitive and social status each were directly associated with disability.
The present results suggest that cognitive and social status might indirectly affect disability incidence through physical aging. Further research is required to examine the temporal relationship between physical, cognitive and social change using data over several time-periods. Geriatr Gerontol Int 2018; 18: 1614-1619.
本研究旨在提出一个结构模型，以解释 75 岁及以上社区居住人群健康状况的生理、认知和社会领域之间的相互作用，从而导致残疾的发生。
我们分析了 185 名年龄在 79.4 岁（58.4%为女性）的老年人，他们参加了 2012 年至 2013 年的基线评估。在接下来的 2 年中，他们根据国家长期护理保险认证系统中护理需求的认证情况进行了随访。基线评估包括与生理、认知和社会健康状况领域相关的多项测量。我们使用结构方程模型比较了两个假设模型（平行模型和层次模型）的模型拟合指数。
在随访期间，有 15 名参与者（8.1%）被新认定为需要长期护理保险系统提供个人支持。结构方程模型表明，层次模型表明认知和社会状况通过生理状况与残疾间接相关，与数据的拟合度优于平行模型，表明生理、认知和社会状况都与残疾直接相关。
本研究结果表明，认知和社会状况可能通过身体老化间接影响残疾的发生。需要进一步研究使用多个时间点的数据来检验身体、认知和社会变化之间的时间关系。老年医学与老年病学国际 2018;18:1614-1619.
